Thread by @evolutionarypsy

I can tell you there is almost no possibility all long Covid cases can be attributed to psychogenic factors. I know Alan likes to be kind and tolerant to discussion but GTFOOH

https://twitter.com/alanlevinovitz/status/1373297760024297478

I see psychogenic physical symptoms all the time. I went to med school due to an interest in this, my supervisor in residency was a Harvard Professor due to his research as a world expert in psychogenic manifestations of illness.

I am referred complex cases specifically due to my expertise in this area.

I also believe that IBS, fibromyalgia, GAD, and MDD are overlapping inflammatory syndromes due to chronic stress. Chronic fatigue is a whole different presentation for the most part, though there are some overlaps.

Chronic fatigue tends to begin after an illness or after an injury in an athletic individual. Higher incidence in women. It’s characterized by worsening with activity. Unlike fibromyalgia, improving sleep quality and graded exercise don’t help.

There is lots of new and exciting research and I can finally refer my CFS patients to a an expert and researcher in the area and not another community rheumatologist who diagnoses them with fibromyalgia. (I love you rheum but the data on this separated 10 years ago)

This is why I lump those conditions (and separate ME/CFS)

https://twitter.com/evolutionarypsy/status/1373345475697446931