It is not generally true that physicians will treat people with somatic diseases well (or at all) if they personally believe symptoms are actually caused by psychological issues.
This is an unproductive, even dangerous thing to tell sufferers.
The issue here is that you did some "brief googling" (your words) on a complicated, confusing, cutting-edge area of clinical research, and now feel competent to state your completely uninformed "null-hypothesis"...
jessriedel, the consensus is that this is a physiological disease with an unknown mechanism. That's why it's an area of active research.
I don't know where you get the idea that the null hypothesis for the cause of any set of symptoms not explained by known biomarkers needs to be "psychosomatic disorder". That's not even wrong - it makes no sense.
> the consensus is that this is a physiological disease with an unknown mechanism
Can you point me towards a statement of that consensus?
> I don't know where you get the idea that the null hypothesis for the cause of any set of symptoms not explained by known biomarkers needs to be "psychosomatic disorder".
I didn't say that, and in particular never used the words you put in quotes and attributed to me. However, I'm pretty comfortable with what I did say: absent evidence to the contrary, a collection of self-reported subjective symptoms with no apparent physiological counterparts is significantly more likely to have a psychological origin. Can you say more about why it doesn't make sense to you? Or point me towards the evidence specific to CFS/ME that makes you think it doesn't fit that description?
Myalgic Encephalomyelitis is not a collection of self-reported subjective symptoms. It never was. Currently the CDC has adopted criteria for which post-exertional malaise is a required symptom. This is measured by 2-day CPET as mentioned elsewhere. I realize that a lot of people don't keep up on this stuff as much as those affected by this illness, but I have to say that it gets a bit tedious having to correct these commonly held, incorrect perceptions about what this illness is. Chronic Fatigue Syndrome is 'tired all the time,' 'fatigue,' sore throats, headaches, muscle & joint pain. Ramsay ME is closer to 'deathlike paralysis.' There's a reason why it was once described as 'atypical polio.' And as has been pointed out elsewhere, while a person suffering from depression is likely to respond positively to exercise, an ME patient responds so negatively that it is to be considered contraindicated, in the strongest possible terms. That's why the Institute of Medicine recommended renaming it to describe exactly what exertion does.
I've seen those links. Is there some particular evidence you're pointing to? Or a position statement by experts concerning a convincing physiological mechanism?
You've seen those links? Have you read them? The third one is a link to the most extensive literature review ever undertaken, and their conclusions were strong enough for them to state flatly in the abstract that this is not psychological or psychiatric.
I'm left wondering exactly what it will take for people to back off this stuff about this being a psych illness. What evidence exactly is required? The volume of studies indicating objectively measurable biological abnormalities is massive. Many are unreplicated due to longstanding funding issues. But while I think most reasonable people would agree that psych issues and/or stress are capable of causing a number of physical issues, I can't imagine we'll ever see anything that suggests that psych issues could possibly come close to affecting the body in the severe ways that Myalgic Encephalomyelitis does.
> You've seen those links? Have you read them? The third one is a link to the most extensive literature review ever undertaken,
I did read those links. The first two conspicuously did not make a claim about a physiological origin, and the third gave a "report" link that led to a paywall.
Thanks! This new link was super useful, and is probably the strongest evidence available on this thread. Do you think that the CDC would endorse the claim about physiological origins in this report? (It's from 2015.) It's notable that the report introduces yet another name and set of defining criteria. As far as I can tell this report does not yet reflect an expert consensus, but I've updated my opinions significantly.
> I'm left wondering exactly what it will take for people to back off this stuff about this being a psych illness.
Can we agree that, given the social and economic implications, there is a huge demand from patients for doctors to issue a diagnosis for various collections of self-report symptoms (not just CFS/ME/SEID)? And that this leads to the potential for bias in the system? Are you not unsettled by the fact that the report you link admits that replication and validity are still big open problems?
I'm generally very worried with the anger and political bent to this thread (though your comments in particular have been very productive and are much appreciated). It just seems more productive try to convince skeptics based on the merits of the evidence, and admit when there remain significant disagreement and uncertainty among experts.
ME/CFS is an under-researched, multi-system disease that affects people in a multitude of ways and is very hard to diagnose. There are no accepted bio-markers yet. There are, however, many well-respected researchers in the field, and more are beginning to enter it from all kinds of disciplines. Basically none of them think this is a psychosomatic illness. This is a good place to start for getting an overview of interesting current research: https://www.omf.ngo/the-end-mecfs-project-2/
Wouldn't the researchers entering this field be selected for thinking this? Their opinion seems less useful than, e.g., a position statement by an encompassing field.
"Position statement" = collective statement by a group of experts on a topic. "Encompassing field" = group of medical experts who study a larger body of knowledge that includes CFS/ME as a subset.
Like, in physics there is a big field of people who study dark matter, with subfields who specializes in certain (often mutually exclusive) hypotheses about what dark matter is made of, e.g., WIMPs, axions, etc. If I wanted to know whether a new hypothesis about dark matter was plausible, I'd want to hear what all the dark matter specialists thought, not just people who already committed to studying that particular hypothesis.
Only on the very surface. Sleep apnea is relatively easy to test for. ME/CFS sufferers experience a kind of fatigue that is distinctly different from that caused by sleep deprivation. Look up PEM / PENE:
Co-founder of Gustav here. Thanks for the kind words :-) The 3% is of course a blended rate. There are positions/sectors where that would never fly, but others where 5% is feasible. Also we cover the full spectrum of what staffing agencies typically offer, including permanent placement type transactions. For those, our take-rate is closer to 20%.
Both are a great choice, both are easy enough to travel to. It's awesome that this is happening. Berlin would draw more people from Eastern Europe, IMHO.
Here in Vienna, we'll have an event with quite a few YC alumni on May 29: http://foundertalks.org
We do not have the means yet to make it free, however. We basically started this a few weeks ago, because we felt that something like startup school is missing in Central Europe. I guess you must have felt the same :-)
EDIT:
P.S.: After our event, I'd be happy to give you some feedback regarding what kind of questions/interestes/etc. European founders voice in such a setting. It's an awesome experiment, I'm really looking forward to it.
You might have noticed (from her screenshots) that she is using Mac OS X.
Simply gaining physical access to the machine should ABSOLUTELY NOT enable an attacker to extract practically all web passwords in something like 15 seconds, without any special tools.
Are you completely ignorant of how the OS X Keychain works and should be implemented application-side, or are you just willfully ignoring it?
I tried Vienna today -- downloaded, installed, then tapped OK on the "Google Sync" option…
…an hour later, the application still was "not responding", though the little red number circle on the dock icon continued to climb. About a half hour later with the application still in a "not responding" state, I force quit and then proceeded to delete it.
Perhaps you're not a very technical person then. Or you have some bizarro ideas about testing new apps.
If an app is "not responding" after one hour, and it's not doing physics simulation or renders a 3D movie for Pixar, then you kill it and try again. Damn, I wouldn't even let it stay stalled for 10 minutes.
If you genuinely want to test the app (instead of only being interested in Google Sync), you'd also try how it does some other stuff, like adding some RSS feeds directly.
