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Kate,

>My physician just told me that CFS patients are usually depressed before they get CFS and that's what the >literature says. I said that wasn't true. We are finally having a showdown about issues like this.

Why bother? I personally wouldn't even dream of

a) wasting time and energy talking to such a doctor,

B) wasting time and energy reading any of the literature that claims to look into "CFS" especially studies that claim to look into the relationship btwn CFS and depression, or studies that have the word "somatisation" in them.

I'm going to do a Tony on you and I'll say just one thing: MOVE ON!

Nelly

[infections] depression and CFS

Can someone help me understand how they came to the conclusion they did, when most of the comparisons between CFS patients and fatigued control subjects were similar? Am I missing something? Or are physicians misinterpreting the conclusion? I mean, isn't it just saying that psychological causes should be looked at because everyone might have them?My physician just told me that CFS patients are usually depressed before they get CFS and that's what the literature says. I said that wasn't true. We are finally having a showdown about issues like this.- Kate D.Depression and somatization in the chronic fatigue syndrome.Lane TJ, Manu P, s DA.Department of Medicine, University of Connecticut School of Medicine, Farmington 06032.PURPOSE: To report the prevalence, clinical features, and diagnostic associations of the proposed chronic fatigue syndrome (CFS) in a cohort of patients with chronic fatigue and to assess the usefulness of a structured psychiatric interview for detecting previously unrecognized psychiatric morbidity in patients with CFS. PATIENTS AND METHODS: A consecutive sample of 200 adult patients with a chief complaint of chronic fatigue was prospectively evaluated in a referral-based clinic within a university general medicine practice. All patients received a thorough medical history, physical examination, diagnostic laboratory testing, and portions of the Diagnostic Interview Schedule, version III-A. The criteria for CFS were applied, and patients with CFS were compared with matched control subjects from the inception cohort. RESULTS: The 60 patients with CFS had similar likelihoods of current psychiatric disorders (78% versus 82%), active mood disorders (73% versus 77%), and preexisting psychiatric disorders (42% versus 43%) when compared with fatigued control subjects. Patients with CFS were more likely to have somatization disorder (p less than 0.001) and to attribute their illness to a physical cause (p less than 0.005) than fatigued controls. Patients with CFS also displayed functional symptoms, often lifelong, which are not part of the case definition of CFS. Depressive features in patients with CFS were similar to those of control subjects, but a trend toward suicidal behavior was noted. CONCLUSIONS: Patients with CFS have a high prevalence of unrecognized, current psychiatric disorders, which often predate their fatigue syndrome. Assessment of patients with CFS should include a structured psychiatric evaluation.PMID: 1951377 [PubMed - indexed for MEDLINE]

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Thanks Nelly,

I have been dealing okay with this physician until he brought up this

whole issue. Obviously he has had it in the back of his mind but never

expressed it before. After thinking it over, I am pretty sure he thinks

I have a somatisation disorder and that the object is my son, whom I am

" making sick, " presumably so I can keep a close relationship with him.

I need to either get a new doctor or confront him with this. I have

looked at somatisation disorder, and whether or not one thinks it's a

legitimate disorder, I don't think I fulfill the criteria. It's pretty

scary though. I can see how doctors would put a lot of their women

patients in this category. I even started falling for it myself when I

saw that a few things matched up. Luckily I remembered that it sounds

unlikely that a sudden onset of swollen knees could be due to such a

thing.

Do you think I should give up on this doctor? Maybe it is totally

impossible to convince someone of one's sanity and mental health. The

more you argue, the more they think you've got the disorder.

I am really pissed off now that I spent my whole morning being upset

about this.

- Kate D.

On Wednesday, January 11, 2006, at 01:48 PM, Nelly Pointis wrote:

> Kate,

>  

> >My physician just told me that CFS patients are usually depressed

> before they get CFS and that's what the >literature says. I said that

> wasn't true. We are finally having a showdown about issues like this.

>  

> Why bother? I personally wouldn't even dream of

>  

> a) wasting time and energy talking to such a doctor,

>  

> B) wasting time and energy reading any of the literature that claims

> to look into " CFS " especially studies that claim to look into the

> relationship btwn CFS and depression, or studies that have the word

> " somatisation " in them.

>  

> I'm going to do a Tony on you and I'll say just one thing: MOVE ON!

>  

> Nelly

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They just want to get you on psych drugs and be done with you. You

can't sleep, I'll give you a little script for Ambien. You know,

your fatigue and ill health can be caused by lack of sleep. Having

some pain, try these COX inhibitors, maybe you're depressed, maybe

you need mothers little helper Prozac to get you through the day.

You go that route and you are screwed, the living dead. Your

neurochemistry will get so far out of whack after tring all kinds of

the latest and greatest prescription crap. You will be running

through the field of flowers in the sunshine with a big smile on

your face. Your disability insurance claim will end after 2 years

and you are now going through life with a psych diagnosis in your

chart and on your MIB. Flush the bastard before he flushes you.

-- In infections , Kate

<KateDunlay@h...> wrote:

>

> Thanks Nelly,

>

> I have been dealing okay with this physician until he brought up

this

> whole issue. Obviously he has had it in the back of his mind but

never

> expressed it before. After thinking it over, I am pretty sure he

thinks

> I have a somatisation disorder and that the object is my son, whom

I am

> " making sick, " presumably so I can keep a close relationship with

him.

>

> I need to either get a new doctor or confront him with this. I

have

> looked at somatisation disorder, and whether or not one thinks

it's a

> legitimate disorder, I don't think I fulfill the criteria. It's

pretty

> scary though. I can see how doctors would put a lot of their women

> patients in this category. I even started falling for it myself

when I

> saw that a few things matched up. Luckily I remembered that it

sounds

> unlikely that a sudden onset of swollen knees could be due to such

a

> thing.

>

> Do you think I should give up on this doctor? Maybe it is totally

> impossible to convince someone of one's sanity and mental health.

The

> more you argue, the more they think you've got the disorder.

>

> I am really pissed off now that I spent my whole morning being

upset

> about this.

>

> - Kate D.

>

> On Wednesday, January 11, 2006, at 01:48 PM, Nelly Pointis wrote:

>

> > Kate,

> >  

> > >My physician just told me that CFS patients are usually

depressed

> > before they get CFS and that's what the >literature says. I said

that

> > wasn't true. We are finally having a showdown about issues like

this.

> >  

> > Why bother? I personally wouldn't even dream of

> >  

> > a) wasting time and energy talking to such a doctor,

> >  

> > B) wasting time and energy reading any of the literature that

claims

> > to look into " CFS " especially studies that claim to look into

the

> > relationship btwn CFS and depression, or studies that have the

word

> > " somatisation " in them.

> >  

> > I'm going to do a Tony on you and I'll say just one thing: MOVE

ON!

> >  

> > Nelly

>

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>Do you think I should give up on this doctor? Maybe it is totally impossible to convince someone of one's >sanity and mental health. The more you argue, the more they think you've got the disorder.

Kate,

Yes, I think you should definitely give up on your doctor, you'll only get yourself and your son into further trouble as he will obviously stick to his guns and who knows where that will lead you. Shades of Munchausen by proxy, you have to be really careful. Doctors can be so pigheaded when they feel out of their depth, when they feel powerless.

You have to use your energy on getting the best possible treatments not on trying to prove you are mentally sane. It is hard enough even when the doctor is on your side, no point in hitting your head against the wall, you'll be needing it to get on to someone else who is TRULY with you, and who believes that you are ill and who will work with you.

Seeing a non-believing doctor is not neutral, it is depressing, and it can be downright dangerous especially if you have children, (with swollen knees!).

Nelly

Re: [infections] depression and CFS

Thanks Nelly,I have been dealing okay with this physician until he brought up this whole issue. Obviously he has had it in the back of his mind but never expressed it before. After thinking it over, I am pretty sure he thinks I have a somatisation disorder and that the object is my son, whom I am "making sick," presumably so I can keep a close relationship with him.I need to either get a new doctor or confront him with this. I have looked at somatisation disorder, and whether or not one thinks it's a legitimate disorder, I don't think I fulfill the criteria. It's pretty scary though. I can see how doctors would put a lot of their women patients in this category. I even started falling for it myself when I saw that a few things matched up. Luckily I remembered that it sounds unlikely that a sudden onset of swollen knees could be due to such a thing.Do you think I should give up on this doctor? Maybe it is totally impossible to convince someone of one's sanity and mental health. The more you argue, the more they think you've got the disorder.I am really pissed off now that I spent my whole morning being upset about this.- Kate D.On Wednesday, January 11, 2006, at 01:48 PM, Nelly Pointis wrote:

Kate, >My physician just told me that CFS patients are usually depressed before they get CFS and that's what the >literature says. I said that wasn't true. We are finally having a showdown about issues like this. Why bother? I personally wouldn't even dream of a) wasting time and energy talking to such a doctor, B) wasting time and energy reading any of the literature that claims to look into "CFS" especially studies that claim to look into the relationship btwn CFS and depression, or studies that have the word "somatisation" in them. I'm going to do a Tony on you and I'll say just one thing: MOVE ON! Nelly

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Dear Kate

I don't believe anyone can rationally understand Manu et al conclusions. Manu, by any fair assessment is unfit to publish, as is Wessely..

The following article may be of interest

http://www.ahmf.org/medpolphillips.htm

The Alison Hunter Foundation from where this came has significant comment.

Regards

Windsor

Ps Try Green & Black's Organic "Maya Gold " chocolate if you can find it,

[infections] depression and CFS

Can someone help me understand how they came to the conclusion they did, when most of the comparisons between CFS patients and fatigued control subjects were similar? Am I missing something? Or are physicians misinterpreting the conclusion? I mean, isn't it just saying that psychological causes should be looked at because everyone might have them?My physician just told me that CFS patients are usually depressed before they get CFS and that's what the literature says. I said that wasn't true. We are finally having a showdown about issues like this.- Kate D.Depression and somatization in the chronic fatigue syndrome.Lane TJ, Manu P, s DA.Department of Medicine, University of Connecticut School of Medicine, Farmington 06032.PURPOSE: To report the prevalence, clinical features, and diagnostic associations of the proposed chronic fatigue syndrome (CFS) in a cohort of patients with chronic fatigue and to assess the usefulness of a structured psychiatric interview for detecting previously unrecognized psychiatric morbidity in patients with CFS. PATIENTS AND METHODS: A consecutive sample of 200 adult patients with a chief complaint of chronic fatigue was prospectively evaluated in a referral-based clinic within a university general medicine practice. All patients received a thorough medical history, physical examination, diagnostic laboratory testing, and portions of the Diagnostic Interview Schedule, version III-A. The criteria for CFS were applied, and patients with CFS were compared with matched control subjects from the inception cohort. RESULTS: The 60 patients with CFS had similar likelihoods of current psychiatric disorders (78% versus 82%), active mood disorders (73% versus 77%), and preexisting psychiatric disorders (42% versus 43%) when compared with fatigued control subjects. Patients with CFS were more likely to have somatization disorder (p less than 0.001) and to attribute their illness to a physical cause (p less than 0.005) than fatigued controls. Patients with CFS also displayed functional symptoms, often lifelong, which are not part of the case definition of CFS. Depressive features in patients with CFS were similar to those of control subjects, but a trend toward suicidal behavior was noted. CONCLUSIONS: Patients with CFS have a high prevalence of unrecognized, current psychiatric disorders, which often predate their fatigue syndrome. Assessment of patients with CFS should include a structured psychiatric evaluation.PMID: 1951377 [PubMed - indexed for MEDLINE]

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Kate

Sorry to chime in here. What you possably need is a major shift in

diagnosis. Swelling in the knee's- blood thickness issues?heart

disease issues?You need to get alternative diagnosis if your blood

is a mess and your heart ain't pumping hard enough-90/50 bp.Then

you can point to these to set your doctor straight.

I found it's important to have these variables that ain't pointing

to perfect health in your charts so that your doctor can see that

your not in the same range as many of his other patients.I just find

you need to accumulate as many of these as possable to get A +

help.A BP of 80/50, 90/50 in medicine is also diagnosable as heart

infection- not!! everything's normal..

>

> > Kate,

> >  

> > >My physician just told me that CFS patients are usually

depressed

> > before they get CFS and that's what the >literature says. I said

that

> > wasn't true. We are finally having a showdown about issues like

this.

> >  

> > Why bother? I personally wouldn't even dream of

> >  

> > a) wasting time and energy talking to such a doctor,

> >  

> > B) wasting time and energy reading any of the literature that

claims

> > to look into " CFS " especially studies that claim to look into

the

> > relationship btwn CFS and depression, or studies that have the

word

> > " somatisation " in them.

> >  

> > I'm going to do a Tony on you and I'll say just one thing: MOVE

ON!

> >  

> > Nelly

>

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Bless you! That's exactly what I need, a social history and analysis of

these assumptions. As an academic, I really relate to that article. I

will be needing support too, because I do feel obliged to seek some

guidance from a psychiatrist for my son (because of some of my own

observations), but my GP will undoubtedly be sending along his views of

the picture, which to my mind are so circular as to be completely

illogical.

I'll look for that chocolate when I'm in the States. My health food

store does have various organic brands but I don't remember seeing that

one.

- Kate

On Wednesday, January 11, 2006, at 06:34 PM, Windsor wrote:

> Dear Kate

> I don't believe anyone can rationally understand Manu et al

> conclusions. Manu, by any fair assessment is unfit to publish, as is

> Wessely..

> The following article may be of interest

> http://www.ahmf.org/medpolphillips.htm

> The Alison Hunter Foundation from where this came has significant

> comment.

> Regards

> Windsor

> Ps Try  Green & Black's Organic " Maya Gold " chocolate if you can find

> it,

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I'll never forget how a year of depression began to melt away after

my first several weeks on clarithromycin. I recall my wife's

jubilance that I actually woke up, got up whistling. Funny how

feeling a little better makes you have a lot less depression. I

wonder, could a toxic system have anything to do with being

depressed??? I took the rest of my amitrypilene/elavil and flushed it.

What a farce.

> >

> > > Kate,

> > >  

> > > >My physician just told me that CFS patients are usually

> depressed

> > > before they get CFS and that's what the >literature says. I

said

> that

> > > wasn't true. We are finally having a showdown about issues like

> this.

> > >  

> > > Why bother? I personally wouldn't even dream of

> > >  

> > > a) wasting time and energy talking to such a doctor,

> > >  

> > > B) wasting time and energy reading any of the literature that

> claims

> > > to look into " CFS " especially studies that claim to look into

> the

> > > relationship btwn CFS and depression, or studies that have the

> word

> > > " somatisation " in them.

> > >  

> > > I'm going to do a Tony on you and I'll say just one thing: MOVE

> ON!

> > >  

> > > Nelly

> >

>

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Kate:

Nelly is giving you good advice.

Because he thinks somehow you are in any way responsible for your son

not feeling well - is cause enough in my mind to drop the guy becuase

this indicates you ARE the problem. And I'd do in it in a careful

way.

Barb

>

>

> Kate,

>

> >My physician just told me that CFS patients are usually

depressed before they get CFS and that's what the >literature says. I

said that wasn't true. We are finally having a showdown about issues

like this.

>

> Why bother? I personally wouldn't even dream of

>

> a) wasting time and energy talking to such a doctor,

>

> B) wasting time and energy reading any of the literature that

claims to look into " CFS " especially studies that claim to look into

the relationship btwn CFS and depression, or studies that have the

word " somatisation " in them.

>

> I'm going to do a Tony on you and I'll say just one thing: MOVE

ON!

>

> Nelly

>

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