Friday, December 10, 2010

Maes & Twisk vs. Harvey & Wessely

Blessing's & thank u all, for ALL u do.
marie moore

pubmed

BMC Med. <javascript:AL_get(this, 'jour', 'BMC Med.');> 2010 Jun 15;8:35.
Chronic fatigue syndrome: Harvey and Wessely's (bio)psychosocial model
versus a bio(psychosocial) model based on inflammatory and oxidative and
nitrosative stress pathways.

Maes M <http://www.ncbi.nlm.nih.gov/pubmed?term=%22Maes%20M%22%5BAuthor%5D>,
Twisk FN<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Twisk%20FN%22%5BAuthor%5D>
.

Maes Clinics @ TRIA, Piyavate Hospital, Bangkok, Thailand. crc.mh@telenet.be
Abstract

BACKGROUND: In a recently published paper, Harvey and Wessely put forward a
'biopsychosocial' explanatory model for myalgic encephalomyelitis/chronic
fatigue syndrome (ME/CFS), which is proposed to be applicable to (chronic)
fatigue even when apparent medical causes are present.

METHODS: Here, we review the model proposed by Harvey and Wessely, which is
the rationale for behaviourally oriented interventions, such as cognitive
behaviour therapy (CBT) and graded exercise therapy (GET), and compare this
model with a biological model, in which inflammatory, immune, oxidative and
nitrosative (IO&NS) pathways are key elements.

DISCUSSION: Although human and animal studies have established that the
pathophysiology of ME/CFS includes IO&NS pathways, these abnormalities are
not included in the model proposed by Harvey and Wessely. Activation of
IO&NS pathways is known to induce fatigue and somatic (F&S) symptoms and can
be induced or maintained by viral and bacterial infections, physical and
psychosocial stressors, or organic disorders such as (auto)immune disorders.
Studies have shown that ME/CFS and major depression are both clinical
manifestations of shared IO&NS pathways, and that both disorders can be
discriminated by specific symptoms and unshared or differentiating pathways.
Interventions with CBT/GET are potentially harmful for many patients with
ME/CFS, since the underlying pathophysiological abnormalities may be
intensified by physical stressors.

CONCLUSIONS: In contrast to Harvey and Wessely's (bio)psychosocial model for
ME/CFS a bio(psychosocial) model based upon IO&NS abnormalities is likely
more appropriate to this complex disorder. In clinical practice, we suggest
physicians should also explore the IO&NS pathophysiology by applying
laboratory tests that examine the pathways involved.

PMID: 20550693 [PubMed - indexed for MEDLINE]PMCID: PMC2901228Free PMC
Article

Images from this publication.See all images
(3)<http://www.ncbi.nlm.nih.gov/images?term=20550693[PMID]>Free
text<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901228/>
  <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901228/figure/F1/>
Figure 1
*The (bio)psychosocial model for 'chronic fatigue' of Harvey and Wessely*.
Chronic fatigue syndrome: Harvey and Wessely's (bio)psychosocial model
versus a bio(psychosocial) model based on inflammatory and oxidative and
nitrosative stress
pathways<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901228/>
BMC Med. 2010;8:35-35.
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901228/figure/F2/>
Figure 2
*The (bio)psychosocial model for myalgic encephalomyelitis/chronic fatigue
syndrome (ME/CFS) of Vercoulen et al.* Fatigue: the subjective feeling of
fatigue; fatigue subscale of the Checklist Individual Strength. Focusing on
(Bodily) Symptoms: somatisation subscale of the Symptom Checklist. (Level
of) Physical Activity: Sickness Impact Profile (SIP) subscale mobility
(SIP-MOB) and the Physical Activities Ratin...
Chronic fatigue syndrome: Harvey and Wessely's (bio)psychosocial model
versus a bio(psychosocial) model based on inflammatory and oxidative and
nitrosative stress
pathways<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901228/>
BMC Med. 2010;8:35-35.
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901228/figure/F3/>
Figure 3
*The inflammatory and oxidative and nitrosative (IO&NS) pathophysiology of
myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)*. COX-2 =
cyclo-oxygenase 2; iNOS = inducible nitric oxide synthase; PUFA =
polyunsaturated fatty acids; NFκB = nuclear factor κB.
Chronic fatigue syndrome: Harvey and Wessely's (bio)psychosocial model
versus a bio(psychosocial) model based on inflammatory and oxidative and
nitrosative stress
pathways<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901228/>
BMC Med. 2010;8:35-35.
   Publication Types, MeSH Terms,
Substances<http://www.ncbi.nlm.nih.gov/pubmed/20550693#>
Publication Types:

   - Comparative Study <javascript:AL_get(this, 'ptyp', 'Comparative
   Study');>
   - Letter <javascript:AL_get(this, 'ptyp', 'Letter');>
   - Review <javascript:AL_get(this, 'ptyp', 'Review');>

MeSH Terms:

   - Fatigue Syndrome, Chronic/immunology* <javascript:AL_get(this, 'mesh',
   'Fatigue Syndrome, Chronic/immunology*');>
   - Fatigue Syndrome, Chronic/pathology* <javascript:AL_get(this, 'mesh',
   'Fatigue Syndrome, Chronic/pathology*');>
   - Free Radicals/toxicity* <javascript:AL_get(this, 'mesh', 'Free
   Radicals/toxicity*');>
   - Humans <javascript:AL_get(this, 'mesh', 'Humans');>
   - Inflammation/pathology* <javascript:AL_get(this, 'mesh',
   'Inflammation/pathology*');>
   - Stress, Physiological* <javascript:AL_get(this, 'mesh', 'Stress,
   Physiological*');>

Substances:

   - Free Radicals <javascript:AL_get(this, 'subs', 'Free Radicals');>

LinkOut - more resources <http://www.ncbi.nlm.nih.gov/pubmed/20550693#>
Full Text Sources:

   - BioMed Central <http://www.biomedcentral.com/1741-7015/8/35>
   - PubMed Central<http://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20550693/?tool=pubmed>
   - PubMed Central
Canada<http://pubmedcentralcanada.ca/articlerender.cgi?tool=pubmed&pubmedid=20550693>
   - UK PubMed Central <http://ukpmc.ac.uk/abstract/MED/20550693>

Medical:

   - Chronic Fatigue Syndrome - MedlinePlus Health
Information<http://www.nlm.nih.gov/medlineplus/chronicfatiguesyndrome.html>

1 comment:

FrankTwisk said...

Landed on this page through Google.

We plan to write an article in which all (bio)psychosocial models are invalidated.

Frank