cbrons

Ratatoskr! *Roar*
10+ Year Member
Jul 29, 2007
6,580
3,675
DEFEND MIDDLE LANE!
Status
  1. Non-Student
Kind of an overly broad question that requires definitional clarification, but I think you get the picture. The purpose of the question is essentially to discuss whether individuals with fibromyalgia require predominantly psychiatric as opposed to medical treatment.
 
Mar 24, 2014
4,400
3,866
Rural Area Medical Facilty
Status
  1. Psychologist
In my experience it is an extremely difficult to treat physiological manifestation of psychological distress. I imagine there are studies that have shown CBT for depression has reduced symptoms of this though. I know there are some with just general chronic pain and I have worked with a few of those individuals with some minimal effect. The medication administration component is extremely challenging with these patients as it can reinforce unhealthy aspects such as dependency and passive coping.
 
About the Ads

birchswing

Non-medical
Nov 17, 2011
1,645
664
I know these aren't the same disorders, but there was a new study that just came out a couple days ago finding a reliable biomarker for chronic fatigue syndrome:

https://www.sciencedaily.com/releases/2016/06/160627160939.htm

I was thinking about making a thread about the study but decided not to since it's rather multi-disciplinary. I thought it might be interesting since psychiatrists likely come across people with CFS and/or people with depression who might straddle such a diagnosis.
 

splik

Professional Cat at Large
Nov 30, 2009
3,801
5,680
Status
  1. Attending Physician
Kind of an overly broad question that requires definitional clarification, but I think you get the picture. The purpose of the question is essentially to discuss whether individuals with fibromyalgia require predominantly psychiatric as opposed to medical treatment.
Psychosomatic refers to somatic conditions which are strongly influenced by psychological factors. Asthma, ulcerative colitis, rheumatoid arthritis and cancer are examples of psychosomatic illnesses. You are referring to somatoform disorders, which are conditions where individuals use a somatic idiom for emotional distress. Many psychiatrists don't appear to understand the difference between the two. Because most chronic medical illnesses are psychosomatic the term is largely useless, however still persists as "psychosomatic medicine" was the only name for a subspecialty of psychiatry the ABPN would accept.

Some would consider fibromyalgia one of the big 5 somatoform disorders - along with chronic fatigue syndrome, irritable bowel syndrome, functional neurological disorder, and chronic pelvic pain. Multiple chemical sensitivities, electromagnetic hypersensitivity syndrome, chronic lyme disease, and MSIDS are some of the latest culture bound somatoform disorders

The most in vogue theory of fibromyalgia and associated pain syndromes is based on theory of central sensitization: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268359/
 

Crayola227

The Oncoming Storm
Oct 22, 2013
16,144
18,334
All of Time & Space
I don't agree.... the rheumatologists are telling me it's real

there's some serotonin - gut connection that supports that IBS is also similarly "real"

by real I mean there's a somatic basis to the illness and it's not "somatoform"

same with chronic fatigue

the rest of the dx thrown out there I can't speak to, just those

OP, you should try this is in the rheum forum, they'll know more about the latest research I'm sure
 
Last edited:
H

HarryMTieboutMD

I don't agree.... the rheumatologists are telling me it's real

there's some serotonin - gut connection that supports that IBS is also similarly "real"

by real I mean there's a somatic basis to the illness and it's not "somatoform"

same with chronic fatigue

the rest of the dx thrown out there I can't speak to, just those

OP, you should try this is in the rheum forum, they'll know more about the latest research I'm sure

Sigh.

Absent people with clear secondary gain, all of these disorders (as much as we roll our eyes at them) are very real to the patients who have them. There is no, consistent pathophysiologic correlate (ie, that directly and consistently confers causality with the clinical syndrome; hence, somatoform), and the ACR's revised criteria are even more vague, nonspecific, and abstruse than the previous version. http://www.rheumatology.org/Practice-Quality/Clinical-Support/Criteria/ACR-Endorsed-Criteria
 
Last edited by a moderator:
  • Like
Reactions: Crayola227
About the Ads

Shikima

10+ Year Member
Oct 15, 2006
4,530
2,656
Status
  1. Attending Physician
Not to mention the Cluster B projection that occurs when discussing the mind-body connection and how psychological distress has manifested into physical symptoms. Same goes for "stress headaches" being diagnosed as "migraine headaches" as a result from chronic muscle tension.
 
Mar 24, 2014
4,400
3,866
Rural Area Medical Facilty
Status
  1. Psychologist
I don't agree.... the rheumatologists are telling me it's real

there's some serotonin - gut connection that supports that IBS is also similarly "real"

by real I mean there's a somatic basis to the illness and it's not "somatoform"

same with chronic fatigue

the rest of the dx thrown out there I can't speak to, just those

OP, you should try this is in the rheum forum, they'll know more about the latest research I'm sure
They are real alright and the dynamic interaction between the head and the gut and the bacteria that live there is quite fascinating. At this point in time, treating the psychological component has been demonstrated to be most effective. The degree to which the patient is able to understand that and actively cope with that aspect as opposed to continue medical tests, procedures, and medications to try and fix it or the degree to which there is secondary gain such as disability is very predictive of outcome. It definitely isn't black and white although the patients with that type of thinking also seem to struggle more.
 
Mar 13, 2013
2,321
3,653
still on the right side of the dirt
Status
  1. Attending Physician
I think the flaw in these arguments is the definition of a psychiatric problem to many doctors means they have something that seems physical, but medicine doesn’t understand the mechanism. Conversion disorders and somatization disorders may have a mostly supra-tentorial origin, but why would this not make it a “real” illness? Just because something is in the DSM does that mean it isn’t “real”?

Of course the flip side is that it shouldn’t surprise us that patients wired to express stress in physical ways often tend to over use other more primitive defense mechanisms excessively. There will always be patients with character disorders who somaticize, and they will also be patients who have somatization disorders who have character disorders. Like in quantum physics, once you look for one or the other, the nature of the matter changes.
 
Feb 27, 2015
2,106
3,529
COPD 50/50 Club
Status
  1. Resident [Any Field]
You are referring to somatoform disorders, which are conditions where individuals use a somatic idiom for emotional distress.

I'm not sure if you're advocating this particular view of somatoform disorder, but it's one of several--the most fair of which, I think, is medically unexplained somatic symptoms.

Otherwise, you're taking us back to the 1920s with Stekel's organsprache--organ speech. Stekel used this word to describe what he said was "the bodily manifestations of deep-seated neuroses." This word was mistranslated as "somatization"--literally, a making of the body--and a concept was born: one that inappropriately intertwined psychoanalysis with a physical phenomenon.

All illness is somatization, literally speaking, because all illness is a making of the body. Some illness is medically explainable, and some illness isn't. Attaching psychoanalytic concepts to illnesses that aren't medically explainable confuses a psychoanalytic explanation for a more accurate one: we have no biological clue of what's going on. A psychoanalytic explanation might be helpful (therapeutically, conceptually, etc.), but we should be careful not to hide our biological ignorance behind words. I'm sure nobody disagrees, but in the history of medicine--not just psychiatry--doctors have been quick to explain away their ignorance in terms of their patient's personal defects, where a failing of medical understanding became a failing of personal character (even the phrase "very real to them" irks me). Cholera and "moral hygiene" is a great example.

And "somatic idiom" was coined by Kleinman to explain the observation that Chinese patients often presented depressive symptoms as somatic ones. These somatic symptoms, he argued, were culturally-specific idioms for depressive symptoms. It had to do with cross-cultural diagnosis in psychiatry. But then the phrase was appropriated (wrongly, I think) to conceptualise somatoform disorder in psychodynamic terms.

We've now learned much more about the biological basis of diseases like depression, and I hope we can keep an open mind to learning more about biological basis for somatoform disorders. That doesn't mean Stekel was wrong. That doesn't mean Stekel was unhelpful. But we should be very careful to distinguish the different intellectual frameworks we use to approach disease (because, as you've pointed out before, diagnosis is a semiotic act).

Just because psychological techniques help, doesn't mean there isn't a biological basis, because ultimately everything is biological, even if everything can't be explained in biological terms.

Lipowski ZJ. Somatization and depression. Psychosomatics. 1990;31(1):13-21.

Kleinman AM. Depression, somatization and the "new cross-cultural psychiatry". Social science & medicine. 11(1):3-10. 1977.

Kind of an overly broad question that requires definitional clarification, but I think you get the picture. The purpose of the question is essentially to discuss whether individuals with fibromyalgia require predominantly psychiatric as opposed to medical treatment.

@cbrons, can you help me understand the difference between psychiatry and medicine?
 
Last edited:

vistaril

7+ Year Member
Jun 10, 2012
3,800
351
Status
  1. Resident [Any Field]
@cbrons, can you help me understand the difference between psychiatry and medicine?

Are the kind of psychiatrist who gets pissed everytime one your patients asks you "is that something I should talk to my medical doctor about"? 99% of the population understands the distinction between mental health and physical health.....and medical doctors and psychiatrists.....even accounting for much of that 99% understanding that psychiatrists did go to medical school at one point.
 
Feb 27, 2015
2,106
3,529
COPD 50/50 Club
Status
  1. Resident [Any Field]
Are the kind of psychiatrist who gets pissed everytime one your patients asks you "is that something I should talk to my medical doctor about"? 99% of the population understands the distinction between mental health and physical health.....and medical doctors and psychiatrists.....even accounting for much of that 99% understanding that psychiatrists did go to medical school at one point.

1) I'm not a psychiatrist.

2) I don't get pissed when patients don't understand, I get confused when doctors don't understand.

Psychiatry is a specialty of medicine that extends beyond medicine to grab helpful concepts from psychology, anthropology, sociology, philosophy, etc. Maybe other specialities would benefit to do the same. Maybe if more cardiologists, for example, considered the social causes of cardiac disease, they'd be placing less stents. Maybe if more doctors considered the philosophical foundations of statistics, they'd stop aggrandising rubbish literature. But just because psychiatry has been intellectually adaptable to the fact that we don't yet understand its biological underpinnings, doesn't mean that it's something else entirely. Again, cholera was a problem of "moral hygiene" until it wasn't. Schizophrenia was a problem of psychological dysfunction until it wasn't. Why should somatoform disorders (or psychiatry) be thought of differently?
 
Last edited:
Oct 13, 2008
2,580
3,328
Status
  1. Attending Physician
The assumption that because something is somatoform that means it isn't "real" really grinds my gears.

That and the people who think pseudoseizures are malingering.


Sent from my iPhone using Tapatalk

I have banished "pseudoseizures" from my vocabulary. "Non-epileptic" is so much more usefully descriptive.

Edit: Corrected autocorrect
 
Last edited:
About the Ads

vistaril

7+ Year Member
Jun 10, 2012
3,800
351
Status
  1. Resident [Any Field]
1) I'm not a psychiatrist.

2) I don't get pissed when patients don't understand, I get confused when doctors don't understand.
/QUOTE]

Why? A medical doctor who has been out in practice for many years may or may not have taken his psych rotation in school seriously(or it may not have even been a serious rotation), but even if he did learn a little about mental health matters then he is going to have forgotten that. That's why he refers to mental health.
 
  • Like
Reactions: Crayola227
Feb 27, 2015
2,106
3,529
COPD 50/50 Club
Status
  1. Resident [Any Field]
Why? A medical doctor who has been out in practice for many years may or may not have taken his psych rotation in school seriously(or it may not have even been a serious rotation), but even if he did learn a little about mental health matters then he is going to have forgotten that. That's why he refers to mental health.

Then that doctor is ignorant. And that's okay. Everybody is ignorant about lots of things. But to blame ignorance on not taking "school seriously" is kinda like calling a duck a duck. And if you're going to speak out of ignorance, then you should have the humility to perhaps have your opinions changed. (To be very, very, very clear, I am not accusing OP or anybody else of anything. I was just engaging a common but perhaps unmerited stereotype with a rhetorical question.)

In Australia, most doctors do terms in psychiatry (as well as ICU, surgery, medicine, etc.--even the psychiatrists!). I think that approach has its benefits. When you're the wannabe surgeon (or whatever) caring for an unwell patient with depression or trying to distinguish nonepileptic seizures from epileptic seizures, you start to think about psychiatry very differently...
 
Last edited:

vistaril

7+ Year Member
Jun 10, 2012
3,800
351
Status
  1. Resident [Any Field]
Then that doctor is ignorant. And that's okay. Everybody is ignorant about lots of things. But to blame ignorance on not taking "school seriously" is kinda like calling a duck a duck. And if you're going to speak out of ignorance, then you should have the humility to perhaps have your opinions changed. (To be very, very, very clear, I am not accusing OP or anybody else of anything. I was just engaging a common but perhaps unmerited dichotomy with a rhetorical question.)

In Australia, most doctors do terms in psychiatry (as well as ICU, surgery, medicine, etc.--even the psychiatrists!). I think that approach has its benefits. When you're the wannabe surgeon (or whatever) caring for an unwell patient with depression or trying to distinguish nonepileptic seizures from epileptic seizures, you start to think about psychiatry very differently...

Wait....you aren't a psychiatrist and you live in Australia? Ok....

I'm just telling you here how it is in the real world. A surgeon here in the US doesn't look at a patient with mental issues and say "hmmm let me see if I can incorporate some of that knowledge I learned 20 years ago during my psychology rotation". He simply tells the unit manager(or whoever) to get mental health to see the patient. He doesn't give a **** if a psychologist, psychiatrist, lcsw, etc sees them...hell he probably doesn't even know the difference. And that's ok.
 
  • Like
Reactions: HarryMTieboutMD
Feb 27, 2015
2,106
3,529
COPD 50/50 Club
Status
  1. Resident [Any Field]
Wait....you aren't a psychiatrist and you live in Australia? Ok....

I'm just telling you here how it is in the real world. A surgeon here in the US doesn't look at a patient with mental issues and say "hmmm let me see if I can incorporate some of that knowledge I learned 20 years ago during my psychology rotation". He simply tells the unit manager(or whoever) to get mental health to see the patient. He doesn't give a **** if a psychologist, psychiatrist, lcsw, etc sees them...hell he probably doesn't even know the difference. And that's ok.

How do we disagree?
 
Last edited:

Ceke2002

Purveyor of Strange
Sep 26, 2009
5,866
4,948
Melbourne
Status
  1. Other Health Professions Student
It sadly doesn't seem to include Australia. :(

Oh we exist, we're just obviously not part of the real world seeing as to find us you have to follow a yellow brick road and ask for directions to Oz - that's Oz the Apocalyptic Wasteland , not Oz the Great and Powerful. I hear it's ruled by some bloke called 'Max'. ;)
 
  • Like
Reactions: OldPsychDoc
About the Ads

Ceke2002

Purveyor of Strange
Sep 26, 2009
5,866
4,948
Melbourne
Status
  1. Other Health Professions Student
I think one of the biggest problems with fibromyalgia (and I can't say if it's somatic, psychosomatic, somatoform of whatever other category it might come under) is that it's far too easy for some Doctors to use it as a wastepaper basket diagnosis - especially if they're presented with a patient who also has a diagnosis of mental health issues. I was originally told I had fibromyalgia, before someone decided to run a some further tests a couple of years later and it turned out I actually had peripheral neuropathy. At the time I was initially diagnosed with fibro, I remember the Rheumatologist starting the exam and noticing some of the self harm scars I have on my body (they're not like mega noticeable, but if someone's looking close enough it's pretty obvious what they're from) and from then on things started focusing more on asking questions about my mental health, which was fine because I understood that stress reduction and keeping things like depression (etc) well controlled are part of a good pain management program, but this was more like 'Oh, okay, you have depression, you've attempted suicide, you have suspicious looking scars and on your arms and legs...wait a minute *prods a few areas* yeah you definitely have fibromyalgia, I can tell that definitively from the perfunctory examination I just performed'. Similar thing happened to a close friend of mine, past history of abuse, diagnosis of depression, anxiety disorder and PTSD, she got slapped with a diagnosis of fibromyalgia when she was experiencing physical symptoms that didn't immediately match into an easy category of diagnosis, and eventually she found out she had some form of parathyroid tumour that was effecting her calcium levels instead.
 

VA Hopeful Dr

Senior Member
Jul 28, 2004
23,319
35,984
Status
  1. Attending Physician
I think one of the biggest problems with fibromyalgia (and I can't say if it's somatic, psychosomatic, somatoform of whatever other category it might come under) is that it's far too easy for some Doctors to use it as a wastepaper basket diagnosis - especially if they're presented with a patient who also has a diagnosis of mental health issues. I was originally told I had fibromyalgia, before someone decided to run a some further tests a couple of years later and it turned out I actually had peripheral neuropathy. At the time I was initially diagnosed with fibro, I remember the Rheumatologist starting the exam and noticing some of the self harm scars I have on my body (they're not like mega noticeable, but if someone's looking close enough it's pretty obvious what they're from) and from then on things started focusing more on asking questions about my mental health, which was fine because I understood that stress reduction and keeping things like depression (etc) well controlled are part of a good pain management program, but this was more like 'Oh, okay, you have depression, you've attempted suicide, you have suspicious looking scars and on your arms and legs...wait a minute *prods a few areas* yeah you definitely have fibromyalgia, I can tell that definitively from the perfunctory examination I just performed'. Similar thing happened to a close friend of mine, past history of abuse, diagnosis of depression, anxiety disorder and PTSD, she got slapped with a diagnosis of fibromyalgia when she was experiencing physical symptoms that didn't immediately match into an easy category of diagnosis, and eventually she found out she had some form of parathyroid tumour that was effecting her calcium levels instead.
That's why its supposed to be a diagnosis of exclusion...
 

Ceke2002

Purveyor of Strange
Sep 26, 2009
5,866
4,948
Melbourne
Status
  1. Other Health Professions Student
That's why its supposed to be a diagnosis of exclusion...

Yeah, exactly. But apparently every other possibility just magically goes *poof* and you're only left with the possibility of fibromyalgia if the patient has any mental health issues.

Internal medicine attending at clinic:

“Oh boy another cutter with complaints of pain and weakness. Slightly high sed. rate, otherwise labs seem normal. Get a psych consult and let us hope they give us permission to stop looking.”

I hate these consults.

Yep, and you can practically see their eyes glaze over at the same time, "Oh god not another one...why do they send all the nutjobs to me"
 

whopper

Former jolly good fellow
Feb 8, 2004
7,159
2,072
Visit site
Status
  1. Attending Physician
There is a possible cure to fibromyalgia. Hyperbaric chamber treatment.
http://www.webmd.com/fibromyalgia/n...-therapy-may-ease-fibromyalgia-study-suggests

Not enough data to say this is solid but it does warrant further study IMHO.

I'm convinced it exists. I know too many industrious people that suffer from it but are hard workers not looking for sympathy. I also (as most people do but seem to not remember this once they get better) have suffered increased sensitivity to pain when I've got an infection. I had a fever about a year ago, and my then 4 year old daughter climbed on my chest which normally doesn't bother me at all and I became very sore from it. Almost everything that touched me caused pain. The increased sensitivity to pain went away with the infection. Yeah that's not fibromyalgia but it certainly helps to see that increased sensitivity can be caused by physiology.

There is data showing hyperbaric chamber treatment does improve neurofunction. IT's been studied with dementia for the same reason but produced no meaningful results with dementia.
 

Ceke2002

Purveyor of Strange
Sep 26, 2009
5,866
4,948
Melbourne
Status
  1. Other Health Professions Student
There is a possible cure to fibromyalgia. Hyperbaric chamber treatment.
http://www.webmd.com/fibromyalgia/n...-therapy-may-ease-fibromyalgia-study-suggests

Not enough data to say this is solid but it does warrant further study IMHO.

I'm convinced it exists. I know too many industrious people that suffer from it but are hard workers not looking for sympathy. I also (as most people do but seem to not remember this once they get better) have suffered increased sensitivity to pain when I've got an infection. I had a fever about a year ago, and my then 4 year old daughter climbed on my chest which normally doesn't bother me at all and I became very sore from it. Almost everything that touched me caused pain. The increased sensitivity to pain went away with the infection. Yeah that's not fibromyalgia but it certainly helps to see that increased sensitivity can be caused by physiology.

There is data showing hyperbaric chamber treatment does improve neurofunction. IT's been studied with dementia for the same reason but produced no meaningful results with dementia.

Agreed. I know a few people as well who have what I believe is a legitimate diagnosis of fibromyalgia - these are people with no history of mental health issues, not using the diagnosis for secondary gain, trying to stay as healthy as possible, still working full time and raising families (in other words not the stereotypical fibromyalgia patient people might otherwise tend to think of). Just because both myself and another friend of mine were misdiagnosed doesn't mean I think the condition doesn't exist at all.

And definitely agreed that physiology can cause increased sensitivity. I'm laid up with shingles at the moment, and things that normally wouldn't bother me (like my cat treading in my lap) are giving me merry hell.
 
  • Like
Reactions: Crayola227
Jun 6, 2016
40
4
Agreed. I know a few people as well who have what I believe is a legitimate diagnosis of fibromyalgia - these are people with no history of mental health issues, not using the diagnosis for secondary gain, trying to stay as healthy as possible, still working full time and raising families (in other words not the stereotypical fibromyalgia patient people might otherwise tend to think of). Just because both myself and another friend of mine were misdiagnosed doesn't mean I think the condition doesn't exist at all.

And definitely agreed that physiology can cause increased sensitivity. I'm laid up with shingles at the moment, and things that normally wouldn't bother me (like my cat treading in my lap) are giving me merry hell.


Poor kitty...
 

nancysinatra

10+ Year Member
Sep 27, 2007
1,499
346
Still walkin'
Status
  1. Attending Physician
Psychiatry is a specialty of medicine that extends beyond medicine to grab helpful concepts from psychology, anthropology, sociology, philosophy, etc.

Such idealism. You must be a medical student. Do a residency, see how much Nietzsche, Durkheim, etc., you read there, and give us a report in about 5 years.
 

nancysinatra

10+ Year Member
Sep 27, 2007
1,499
346
Still walkin'
Status
  1. Attending Physician
I have banished "pseudoseizures" from my vocabulary. "Non-epileptic" is so much more usefully descriptive.

Edit: Corrected autocorrect

That's a shame. Because "pseudo" has a specific meaning in medicine. My favorite medical condition ever is probably pseudopseudohypoparathyroidism. I suppose you'd probably want to change that to "non-hypoparathyroidism non-hypoparathyroidism."
 

nancysinatra

10+ Year Member
Sep 27, 2007
1,499
346
Still walkin'
Status
  1. Attending Physician
Then that doctor is ignorant. And that's okay. Everybody is ignorant about lots of things. But to blame ignorance on not taking "school seriously" is kinda like calling a duck a duck. And if you're going to speak out of ignorance, then you should have the humility to perhaps have your opinions changed. (To be very, very, very clear, I am not accusing OP or anybody else of anything. I was just engaging a common but perhaps unmerited stereotype with a rhetorical question.)

In Australia, most doctors do terms in psychiatry (as well as ICU, surgery, medicine, etc.--even the psychiatrists!). I think that approach has its benefits. When you're the wannabe surgeon (or whatever) caring for an unwell patient with depression or trying to distinguish nonepileptic seizures from epileptic seizures, you start to think about psychiatry very differently...

Yeah, I doubt Australian surgeons are any more keen to deal with psych stuff than American surgeons.
 
  • Like
Reactions: HarryMTieboutMD
Feb 27, 2015
2,106
3,529
COPD 50/50 Club
Status
  1. Resident [Any Field]
Such idealism. You must be a medical student. Do a residency, see how much Nietzsche, Durkheim, etc., you read there, and give us a report in about 5 years.

Fair enough. And yes, I am idealistic (though not unrealistic). And no, I hope I don't grow wizened over time.

My point was this: out of all three countries I've worked in, either as a healthcare consultant or a medical student/Sub-I, I've never experienced the same level of outright hostility or disregard for psychiatry than in the US--vocal, eyerolling, dismissive, "it's a waste." That might have to with more meaningful exposure than anything else.

Yeah, I doubt Australian surgeons are any more keen to deal with psych stuff than American surgeons.

Maybe not deal, but the stigma appears less. And actually, there is an openly bipolar surgery registrar at our hospital. He speaks at the mental health forums organised for junior doctors. We also have no-risk-disclosure on our residency applications, so that reasonable accommodations can be made for sleep hygiene, etc. It doesn't have to be any different anywhere else...
 
Last edited:

Ceke2002

Purveyor of Strange
Sep 26, 2009
5,866
4,948
Melbourne
Status
  1. Other Health Professions Student
Actually, there is an openly bipolar surgery registrar at our hospital. He speaks at the mental health forums organised for junior doctors.

Interesting, I know there's a surgeon in Adelaide who's diagnosed with Schizophrenia (well controlled, still able to practice). Not sure if he's involved in any mental health forum stuff, but it would seem his colleagues in the medical profession are aware of his condition, and no one's run screaming from the operating room yet, so it seems like his mental illness history is a moot point.
 
  • Like
Reactions: lymphocyte

Crayola227

The Oncoming Storm
Oct 22, 2013
16,144
18,334
All of Time & Space
yeah the only out bipolar physicians I know are attendings that have their **** 100% together, and if dude is a surgeon I'm guessing he went through more on the hypomanic side of things

I read a story of bipolar FM doc in CA who had successfully practiced 30 years who lost his license over politics and his diagnosis was used against him

there's a reason there's attorneys that essentially specialize in representing docs with MH issues to the med board

If it were me, I would not be out about that stuff until well into attending-hood, if at all
 
Oct 13, 2008
2,580
3,328
Status
  1. Attending Physician
That's a shame. Because "pseudo" has a specific meaning in medicine. My favorite medical condition ever is probably pseudopseudohypoparathyroidism. I suppose you'd probably want to change that to "non-hypoparathyroidism non-hypoparathyroidism."

If you wanna go pedantic, let's get pedantic up in here.

1) "Pseudo" does not and has never meant simple negation, i.e. "not" or "non". Pseudo means "false". Always has.

2) Pseudo in the context of seizures is not a term of art conveying some subtlety of meaning. It is saying "these seizures aren't real". Note the alternative is saying "these seizures aren't epilepsy." You are a big fan of objective tests; as I understand it it is part of why you are leaving psychiatry.

Which conclusion do you think is better supported by EEG? If the first, please explain to me what electrophysiological findings demonstrate faking.
 
Last edited:
This thread is more than 4 years old.

Your message may be considered spam for the following reasons:

  1. Your new thread title is very short, and likely is unhelpful.
  2. Your reply is very short and likely does not add anything to the thread.
  3. Your reply is very long and likely does not add anything to the thread.
  4. It is very likely that it does not need any further discussion and thus bumping it serves no purpose.
  5. Your message is mostly quotes or spoilers.
  6. Your reply has occurred very quickly after a previous reply and likely does not add anything to the thread.
  7. This thread is locked.
About the Ads