"Verdedigen van het onverdedigbare" is de reaktie van Margaret Williams op "Health in Mind en Body" van prof. Wessely in
The Journal of the Foundation for Science and Technology.
Defending the indefensible?
Margaret Williams 27th December 2011
NB: De tekst tussen aanhalingstekens zijn quotes uit artikelen van Prof. Wessely.
...
"A landmark trial on the management of CFS, known as the PACE Trial,
was published recently in The Lancet ...
Two treatments, graded exercise and CBT, clearly made a difference,
although they were certainly not 'magic bullets'":
Not only were the interventions used in the PACE Trial very far from being magic bullets,
the Chief Principal Investigator himself described them as being "only moderately effective".
...
"We now have two treatments that we can recommend with confidence to our patients.
However, the story does not quite end there.
Patient groups rejected the trial out of hand,
and the internet was abuzz with abuse and allegations.
The main reason for this depressing reaction was
the stigma that attaches to disorders
perceived (rightly or wrongly) to be psychiatric in origin."
The reason people with ME/CFS reject CBT and GET is because they do not work,
but Wessely refuses to accept this,
so he here provides an explanation already shown by his own research to be incorrect.
He has previously written:
"CFS sufferers are also usually portrayed as
hostile to psychological explanation, mental illness, and psychiatry in general ...
This study aims to investigate attitudes of CFS patients to psychiatric illness
(and) a comparison group of patients with rheumatoid arthritis (RA) was chosen ...
We began with the following hypotheses:
CFS patients have more negative attitudes to mental illness ...
(represented by the perceived stigma of psychiatric illness) ...
(and) failure to identify emotional states (alexithymia)
contributes to denial of the role of psychiatric disorders in the aetiology of CFS ...
Contrary to our hypotheses and the media accounts of CFS,
we found no evidence that CFS patients are characterized by
particularly hostile attitudes to mental distress ...
Our study also failed to demonstrate any overall differences in personality traits
that may underlie negative attitudes to mental illness or psychiatry ...
The ... alexithymia scores found in the CFS compared with the RA patients
were contrary to our original hypothesis ...
There was no difference between CFS and RA patients in hostility to mental illness ...
This study provides no evidence to support the anti-psychiatry tone
that is so striking in the popular literature on CFS"
(Personality and Social Attitudes in Chronic Fatigue Syndrome.
Barbara Wood and Simon Wessely; J Psychsom Res 1999:47:4:385-397).
...
Why is it that the Wessely School,
who claim to be so committed to evidence-based medicine (EBM),
are permitted to continue to disregard the evidence
that proves them to be wrong
about the nature of ME and about the efficacy of GET in those suffering from it?
The answer may be because,
like so many of the Wessely School myths,
EBM does not actually exist.
...
(Zombie science of Evidence-Based Medicine.
Bruce G Charlton.
Journal of Evaluation in Clinical Practice 2009:15:930-934).
...
Retrovirology apart,
there is now undeniable evidence of multi-system damage in ME/CFS,
including inflammation of the blood vessels, hypoperfusion of the brain,
delayed recovery of muscles after exercise,
dysfunction of the immune and neuroendocrine systems,
and evidence of marked abnormalities in gene expression profiling.
http://www.meactionuk.org.uk/Defending-the-indefensible.htm
Unexplained symptoms
Unexplained symptoms represent a huge burden of costs within the healthcare system.
...
Another example, Chronic Fatigue Syndrome (CFS),
illustrates the gap that lies between
physical health/illness on the one hand and mental health/illness on the other.
...
The illness is then
a complicated mixture of predisposition, precipitation and perpetuation.
In terms of treatment we know that
antidepressants, diets, vitamins, allergy treatments, etc, do not work.
On the other and,
understanding what people think about their illness and how they respond to symptoms,
does seem to help.
A landmark trial on the management of CFS, known as the PACE Trial,
was published recently in The Lancet.
...
Two treatments, graded exercise and CBT,
clearly made a difference,
although they certainly were not magic bullets.
For those who appreciate these things,
the trial is a thing of beauty,
and the results confirm previous smaller studies and follow ups.
We now have two treatments
that we can recommend with confidence to our patients.
However, the story does not quite end there.
Patient groups rejected the trial out of hand,
and the internet was abuzz with abuse and allegations.
...
http://niceguidelines.files.wordpress.com/2011/12/fst_20_07.pdf
Met dank aan dr. Speedy en Margaret Williams.
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