Wednesday, October 28, 2009

'Chronic Fatigue Syndrome: la bête noire of the Belgian Health Care System'

'Chronic Fatigue Syndrome: la bête noire of the Belgian Health Care System'
Maes M, Twisk FN.
Neuro Endocrinol Lett. 2009 Aug 26;30(3):300-311.
Maes Clinics, Antwerp, Belgium.

The World Health Organization acknowledges Myalgic Encephalomyelitis
(ME)/Chronic Fatigue Syndrome (CFS) to be a medical illness. ME/CFS is
characterized by disorders in the inflammatory and oxidative and
nitrosative stress (IO&NS) pathways. In 2002, the Belgian government
started with the development of CFS "Reference Centers", which
implement a "psychosocial" model. The medical practices of these CFS
Centers are defined by the Superior Health Council, e.g. treatment
should be based upon Cognitive Behavioral Therapy (CBT) and Graded
Exercise Therapy (GET); and biological assessments and treatments of
ME/CFS should not be employed. Recently, the Belgian government has
evaluated the outcome of the treatments at the CFS Centers. They
concluded that a "rehabilitation therapy" with CBT/GET yielded no significant efficacy in the treatment of ME/CFS and that CBT/GET cannot be considered to be curative therapies. In case reports, we
have shown that patients who were "treated" at those CFS centers with
CBT/GET in fact suffered from IO&NS disorders, including intracellular
inflammation, an increased translocation of gram-negative
enterobacteria (leaky gut), autoimmune reactions and damage by O&NS
Considering the fact that these findings are exemplary for ME/CFS patients and that GET may even be harmful, it means that many patients are maltreated by the Belgian CFS Centers. Notwithstanding the above,
the government and the CFS Centers not only continue this unethical
and immoral policy, but also reinforce their use of CBT/GET in
patients with ME/CFS treated at those Centers.

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