Chronic fatigue syndromes: real illnesses that people can recover from.

The 'Oslo Chronic Fatigue Consortium' consists of researchers and clinicians who question the current narrative that chronic fatigue syndromes, including post-covid conditions, are incurable diseases. Instead, we propose an alternative view, based on research, which offers more hope to patients. Whilst we regard the symptoms of these conditions as real, we propose that they are more likely to reflect the brain's response to a range of biological, psychological, and social factors, rather than a specific disease process. Possible causes include persistent activation of the neurobiological stress response, accompanied by associated changes in immunological, hormonal, cognitive and behavioural domains. We further propose that the symptoms are more likely to persist if they are perceived as threatening, and all activities that are perceived to worsen them are avoided. We also question the idea that the best way to cope with the illness is by prolonged rest, social isolation, and sensory deprivation.Instead, we propose that recovery is often possible if patients are helped to adopt a less threatening understanding of their symptoms and are supported in a gradual return to normal activities. Finally, we call for a much more open and constructive dialogue about these conditions. This dialogue should include a wider range of views, including those of patients who have recovered from them.

Prevalence of psychiatric disorders in sick listed chronic low back pain patients.

BACKGROUND: Previous findings have shown a high degree of comorbid psychopathology in chronic low back pain (CLBP), but less is known about the broad range of comorbid psychiatric disorders. The prevalence is reported to be between 40% and 100% depending on methods being used, sample or setting. AIMS: To assess the prevalence of psychiatric comorbidity in a population of CLBP patients, using a psychiatric diagnostic interview. METHODS: 565 patients sick listed between 2 and 10months for unspecific LBP were included in the study. All were recruited as part of an ongoing trial in secondary care, and were assessed with the Mini-International Neuropsychiatric Interview (MINI), which is a short structured diagnostic interview for DSM-IV and ICD-10 psychiatric disorders. RESULTS: The prevalence of current psychiatric disorders was 31%. The diagnoses included 19 Axis I disorders, with the most common being somatoform disorders (18%) and anxiety disorders (12%). Major depressive disorders were reported in 4%. There were no gender differences in prevalence of psychiatric disorders. CONCLUSIONS: In a large population of CLBP patients, 31% fulfilled the criteria for at least one current psychiatric disorder when measured with a diagnostic interview. The diagnoses included a wide range of psychiatric disorders, with the most common being somatoform disorders (18%) and anxiety disorders (12%). The results imply that screening CLBP patients for psychiatric comorbidity in secondary care is important since psychopathology may have serious consequences for prognosis, outcome and health care utilization.