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Lucibee 🌻 Profile picture
@_Lucibee
Mar 5, 2021 • 23 tweets • 6 min read • Read on X
Sir Mansel Aylward talks about his experience of #LongCovid
bbc.co.uk/news/uk-wales-…
I hope his reflections go slightly deeper than just the UK's unpreparedness... meassociation.org.uk/2011/11/privat…
Further reading from @TommyShakes | Blaming the victim, all over again: Waddell and Aylward's biopsychosocial (BPS) model of disability
journals.sagepub.com/doi/abs/10.117…
More further reading: Getting rich on disability denial @RedPeppermag redpepper.org.uk/getting-rich-o…
Psychological tyranny prescribed by the DWP: preventable harm is government policy | B J Gen Pract 2018
ncbi.nlm.nih.gov/pmc/articles/P…
Who is Prof Sir Mansel Aylward? lshubwales.com/board/professo…
Problems in the assessment of psychosomatic conditions in Social Security benefits and related commercial schemes | J Psychosom Res 1995 pubmed.ncbi.nlm.nih.gov/8568732/
"Some diagnoses are purely subjective by definition..." Image
Models of sickness and disability | Waddell and Aylward 2010 webility.md/praxis/downloa…
Who was Gordon Waddell journals.lww.com/pain/Citation/…
Part of the problem is the assumption that such a "medical model" actually exists. Image
When actually this seems to be a description of one of a number of different scenarios, where the ideal "model" is at the top. Image
Another big assumption about the "medical model" is that it makes assumptions. Image
From my own experience, application of BPS in healthcare, rather than addressing complex issues in a multifactorial way, essentially reduces it to "guided self-help", and further exacerbates the problem.
Dog whistle medicine and disability denial - Unum, Aylward and the "Wessely School"
Aylward also contributed a section to the Trends in Health and Disability 2002 report (Unum) - it's quite dry though. The section by a certain Dr Sharpe is more interesting... web.archive.org/web/2003012615…
"Both State and private insurers pay people to remain ill."
Nice dig at patient support groups and charities there too. 😠 Image
No mate, biggest obstacle to recovery is lack of effective treatments. Image
Sharpe mentions the 2002 CMO report, which I linked to here:
"Neither classification [DSM-IV vs ICD-10] is ideal."
aka "We're not saying that it's psychological... (but it's psychological.)" Image
"The trial was co-designed with a patient group."
Image
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More from @_Lucibee

Lucibee 🌻 Profile picture
Aug 25
This was a very good phone-in show, and well worth a listen in full.
#GreatestMEdicalScandal

It was particularly interesting to hear what Wessely had to say, and I'll come on to that below, because he has said many, many things about this over the years.
First of all, his complaints about the torrent of people seeking diagnoses for autism and ADHD.
This is what he said about a very similar thing in 2002: Text of extract reads: But more commonly the act of giving a name to symptoms and disability brings relief. The acknowledgement by the medical profession that a patient's condition has a name and is a legitimate illness is immensely reassuring and enabling. It also ends the battle of diagnosis—“If you have to prove you are ill you can't get well.” Giving a condition a name is an intervention in itself with costs and benefits. Crudely handled, medicalisation can perpetuate disability and exclusion. But used constructively and appropriately it is the first step towards recovery.
What's more interesting is that Wessely issued a statement to the show to say that he had "never suggested that ME or chronic fatigue syndrome were non-diseases".
Oh... but what's this...? "Taking chronic fatigue syndrome as an example from the debate, few could now question that it is indeed an illness. It has a nosological status and is clearly associated with suffering, ill health, and disability. The patient's voice must be and is paramount. But is it a disease—that is, has a specific pathological process been identified to account for the above? Chronic fatigue syndrome is not yet a disease because no unambiguous evidence has yet been presented that has commanded widespread acceptance by the scientific community, which remains the arbiter. Of course, the syndrome m...
Read 8 tweets
Lucibee 🌻 Profile picture
Jul 31
"Can't separate" or "*won't* separate"?

BPS proponents have done soooo much damage to the notion of holistic healthcare.

To see the whole person, you also need to see all the parts. And vice versa.
And, yes, of course every disease (condition) has a psychological component, because they all tend to occur in conscious human beings with brains! 🙄
The whole point of Engel's thesis (as far as I see it) was to ensure that the patient wasn't left out of the treatment of their disease.
Practical things, like not referring a patient who can't drive to an appointment 2 hours' drive away.
Read 9 tweets
Lucibee 🌻 Profile picture
Jul 23
If it helps, I'm going to try to put together a thread of tweets from #MaeveInquest, so that those there/online can concentrate on what's said and don't have to worry about threading.
#MaeveInquest Day 2 - Dr Strain
#MaeveInquest Day 2 - Dr Strain
Read 53 tweets
Lucibee 🌻 Profile picture
Jan 16
The #PACEtrial is a prime example of how the current medical publishing model doesn't work.
😲that a study so flawed can remain in print and in prominence for so long, without any correction or even investigation.
Everyone @TheLancet involved should be ashamed of themselves. Image
Dozens of letters were sent to @TheLancet after publication to point out serious methodological errors.
Some were published (start here: )
but not a single correction has been made.thelancet.com/journals/lance…
@TheLancet In their response, the authors simply reiterate what they did, and fail to address the queries posed by the correspondents.
As a former Correspondence copyeditor for The Lancet, this sort of thing used to annoy me all the time.
Read 9 tweets
Lucibee 🌻 Profile picture
Nov 1, 2023
Many folks are retweeting this - but have you actually read as far as the section on "Psychological disorders and long COVID" which seems to be completely at odds with the rest of the review. 🤔
"...psychological and psychosomatic factors exert an indispensable role in the progression of long COVID..."
🤔
It also seems to (somewhat?) misquote current NICE guidance on ME/CFS, as recommending:
"energy management, personalized exercise or physical activity, personalized sleep management, and dietary management"
Or is this OK? 🤷‍♀️
Read 17 tweets
Lucibee 🌻 Profile picture
Oct 13, 2023
Note that both the experts on "Long Covid" in this morning's session are probably going to be looking at post-ICU Long Covid as they are respiratory physicians from the PHOSP Covid study.
#UKCovidInquiry
One of the main issues with this inquiry is that it only looks at what was done, and not what *should* have been done.
And only asking those who "did" what should have been done is going to give a quite distorted picture.
#UKCovidInquiry
Module 2 deals with "Core UK decision-making and political governance"
Long Covid was a major blindspot. It didn't feature in any decision-making or political governance, at least not until too late.
The @covidinquiryuk is not asking the right questions about that.
Read 34 tweets

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