Why is CFS/ME considered a psychiatric condition?

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Fogbound
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by Fogbound on Thu Aug 15, 2013 8:21 pm

Why is CFS/ME considered a psychiatric condition?

Thanks for providing this online clinic!

Could someone explain why CFS/ME is considered a psychiatric condition and is treated by mental health departments? Is it purely because it is medically unexplained? Or is it believed that everyone with it has an underlying mental illness/disorder or maladaptive behaviour/personality traits that is causing the symptoms?

ithought
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by ithought on Fri Aug 16, 2013 5:43 am

Re: Why is CFS/ME considered a psychiatric condition?

I don't think you can speak for all 'NHS employers when you say you don't treat it as a paychiatric condition I have been told often enough in the last three years that it is... Sadly education about ME is still very out of date in some areas of the UK...

MichaelC
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by MichaelC on Fri Aug 16, 2013 8:09 am

Re: Why is CFS/ME considered a psychiatric condition?

ME/CFS is classified as a long-term neurological condition of unknown cause by the Department of Health as they have confirmed many times.

We have mostly moved on from ME/CFS being considered psychiatric per se by anyone much a while ago. Even though a good number of those with it have a psychological component either as part of their illness or as a reaction to it. Specialist teams and others working in the field recognise that psychological elements are sometimes present and need addressing along with the other symptoms.

Thankfully these days we have some very good NHS specialist multidisciplinary teams such as Dr Miller's working across the country and these deserve applauding.

craigmorris
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by craigmorris on Fri Aug 16, 2013 4:05 pm

Re: Why is CFS/ME considered a psychiatric condition?

Those with personal experience of ME or expert training wouldn't consider ME sufferers to have a psychiatric condition but in my personal experience many Drs and nurses do. What is being done to improve education and training of health professionals?

Bluebottle
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by Bluebottle on Fri Aug 16, 2013 4:09 pm

Re: Why is CFS/ME considered a psychiatric condition?

All illnesses have a 'psychological component'. Why is the psychological component of the neurological illness myalgic encephalomyelitis the only part of this devastating physical illness being researched and 'treated'?

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Dr Charles Shepherd
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by Dr Charles Shepherd on Fri Aug 16, 2013 4:11 pm

Re: Why is CFS/ME considered a psychiatric condition?

One of the actions the MEA is currently doing to improve GP education is to send out fee copies of our 52 page guidelines on research, clinical assessment and management

Since publication a couple of months ago we have sent out well over 2,000 copies

If anyone wants a copy sent to a GP please send contact details to Gill Briody at MEA Head Office

MEA purple booklet:

http://www.meassociation.org.uk/?p=4038
Dr Charles Shepherd
MB BS, Honorary Medical Adviser, ME Association

Richio76
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by Richio76 on Sat Aug 17, 2013 1:24 pm

Re: Why is CFS/ME considered a psychiatric condition?

Dr Alastair Miller wrote:You are certainly correct that ME/CFS is a "medically unexplained syndrome" - that is we do not have an explanation of the mechanism that underpins the collection of symptoms that we recognise as constituting the syndrome. However, nobody treating CFS /ME in the NHS believes "it is a psychiatric condition". Many different specialties take a lead in caring for patients with ME/CFS and they include endocrinology, neurology, immunology, infectious disease and psychiatry. In my organisation it is infectious disease physicians who make the diagnosis of ME/CFS and then a multi-disciplinary team of nurses, therapists and clinical psychologists who provide therapy. None of us regard it as a "psychiatric condition"
I wish you were right but sadly you aren't. Indeed, only recently Robert Winston described CFS/ME as a psychiatric condition in the House of Lords. The vast majority of psychiatrists consider it to be that and sadly a great deal of other clinicians. In the last two years I've seen a GP, neurologist and psychiatrist who made that clear to me. In the relatively recent book "confessions of a GP" the author describes the illness as "shit life syndrome", affecting mostly the poorer classes. I'm a middle class lad from a happy home who was successful and enjoying life a great deal. Having been ill for 16 years I suffered from depression for the first time ever two years ago after an ME relapse which had significant consequences for my personal, family and working life. I became depressed because I had relapsed. Throughout my treatment it was assumed and inferred that my relapse wasn't because I took on far too much and exceeded my limitations for far too long but that my symptoms were simply a consequence of my depression. "Chronic Fatigue Syndrome associated with depression".

I wish your assertions above were true. There is no excuse for such prehistoric attitudes in the NHS today but psychiatrists and psychologists are still taught that it is a psychiatric condition and other medics are taught little about it at all, forming their opinions from the attitudes of their peers and the predominance in this country of published papers and studies focusing solely on the biopsychosocial model of the illness, something that has been reinforced by the vastly overstated and manipulated results of the PACE trial. Indeed, PACE has been raised with me by doctors from three specialities in the last 18 months, all three parroting the author's dogma.

I welcomed the MEA's "telling doctors the truth" campaign because, sadly, a large proportion of them at best are poorly informed, at worst dismissive and hostile.

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