{"id":26380,"date":"2020-06-08T07:38:07","date_gmt":"2020-06-08T07:38:07","guid":{"rendered":"https:\/\/wames.org.uk\/cms-english\/?p=26380"},"modified":"2020-06-08T07:38:07","modified_gmt":"2020-06-08T07:38:07","slug":"the-concept-of-illness-without-disease-impedes-understanding-of-cfs-a-response-to-sharpe-greco","status":"publish","type":"post","link":"https:\/\/wames.org.uk\/cms-english\/the-concept-of-illness-without-disease-impedes-understanding-of-cfs-a-response-to-sharpe-greco\/","title":{"rendered":"The concept of \u2018illness without disease\u2019 impedes understanding of CFS: a response to Sharpe & Greco"},"content":{"rendered":"

The concept of \u2018illness without disease\u2019 impedes understanding of chronic fatigue syndrome: a response to Sharpe and Greco<\/a>, by Steven Lubet, David Tuller in<\/span> BMJ Medical Humanities.<\/em> Published Online First: 01 June 2020. [doi: 10.1136\/medhum-2019-011807]<\/h3>\n

 <\/p>\n

Article abstract:<\/strong><\/h3>\n

In a recent article<\/a> in Medical Humanities, Sharpe and Greco characterise myalgic encephalomyelitis\/\u00a0 chronic fatigue syndrome (ME\/CFS) as an \u2018illness without disease\u2019, citing the absence of identified diagnostic markers.<\/p>\n

\"\"They attribute patients\u2019 rejection of psychological and behavioural interventions, such as cognitive\u2013behavioural therapy (CBT) and graded exercise therapy (GET), to a \u2018paradox\u2019 resulting from a supposed failure to acknowledge that \u2018there is no good objective evidence of bodily disease\u2019.<\/p>\n

In response, we explain that understandings about the causes of and treatments for medical complaints have shifted across centuries, and that conditions once thought to be \u2018psychosomatic\u2019 have later been determined to have physiological causes.<\/p>\n

We also note that Sharpe and Greco do not disclose that leading scientists and physicians believe that ME\/CFS is a biomedical disease, and that numerous experts, not just patients, have rejected the research underlying the CBT\/GET treatment approach.<\/p>\n

In conclusion, we remind investigators that medical classifications are always subject to revision based on subsequent research, and we therefore call for more humility before declaring categorically that patients are experiencing \u2018illness without disease\u2019.<\/p>\n

Read full article<\/a><\/p>\n

Read summary of article by Steven Lubet<\/strong>: Is ME\/CFS an “Illness without Disease”?<\/a><\/p>\n

No. No it is not. No matter what certain psychiatrists have opined..<\/p>\n

…Given psychiatry\u2019s long history of mistaken theories of disease
\ncausation, there is an almost wondrous grandiosity to Sharpe and
\nGreco\u2019s proposed solution to the supposed \u201cparadox\u201d that troubles
\nthem. Rather than conceding that CBT and GET may be failed therapies
\nfor ME\/CFS, and that biomedical research may ultimately hold the key,
\nthey instead call for \u201ca major long-term change in thinking\u201d on the
\npart of patients, clinicians and scientists who do not share their
\nparticular views regarding the \u201cmoral connotations of illness and
\ndisease\u201d.<\/p>\n

The illness-without-disease concept can be a useful tool in
\nexploring interactions between patients and health care systems, but
\nonly if it is recognized as highly contingent and subject to the
\nadmitted limitations of current knowledge. Contra Sharpe and Greco,
\npatients would be better served by greater humility accompanied by an
\nunderstanding that medical categories are always provisional and
\ntherefore subject to change with advances in research.<\/p>\n","protected":false},"excerpt":{"rendered":"

The concept of \u2018illness without disease\u2019 impedes understanding of chronic fatigue syndrome: a response to Sharpe and Greco, by Steven Lubet, David Tuller in BMJ Medical Humanities. Published Online First: 01 June 2020. [doi: 10.1136\/medhum-2019-011807]   Article abstract: In a … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[1834,11,426,10,481,5238,310,5940,2150,2221,3096],"class_list":["post-26380","post","type-post","status-publish","format-standard","hentry","category-news","tag-biomedical-research","tag-cbt","tag-cognitive-behavioural-therapy","tag-get","tag-graded-exercise-therapy","tag-monica-greco","tag-pace-trial","tag-prof-david-tuller","tag-prof-michael-sharpe","tag-psychosomatic","tag-steven-lubet"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p5qkYK-6Ru","_links":{"self":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/26380","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/comments?post=26380"}],"version-history":[{"count":2,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/26380\/revisions"}],"predecessor-version":[{"id":26443,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/26380\/revisions\/26443"}],"wp:attachment":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/media?parent=26380"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/categories?post=26380"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/tags?post=26380"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}