15.06.10 publiserte BMC Medicine Michael Maes og Frank Twisk sitt bio(psykologiske) studie som står som motvekt og kritikk til det (bio)psykologiske studie publisert av Wessley og Harvey i BioMed Central 12.10.09.
Maes og Twisk skriver følgende:
«we substantiate why the Harvey and Wessely model for ME/CFS (‘unexplained fatigue’) (http://www.biomedcentral.com/1741-7015/7/58/figure/F1) is incoherent and invalid, and why the label biopsychosocial model is inappropriate.
A pathophysiological model for ME/CFS should incorporate the precipitating and perpetuating factors and the biological aberrations (induced and/or maintained by these factors), which can plausibly explain specific symptoms.
As an alternative to the model of Harvey and Wessely and other (bio)psychosocial models, we outline a bio(psychosocial) model for ME/CFS, in which (persistent and/or reactivating) infections, immunological abnormalities (inflammation, immune activation, immunosuppression and immune dysfunction), oxidative and nitrosative stress, and their sequels (e.g. mitochondrial dysfunction and channelopathy) are key players.
These biological aberrations account for many of the symptoms characteristic for ME/CFS, e.g. «fatigue», neurocognitive impairment, and pain.
Since physiological and psychological stress intensify the immunological abnormalities (inflammation, immunosuppression and immune dysfunction) and oxidative and nitrosative stress, it is not surprising that ‘behaviorally oriented programs’, like CBT/GET, as proposed by Harvey and Wessely, amplify many symptoms, as has been observed by various authors.
We conclude that it is about time to leave the (bio)psychosocial explanatory model(s) for ME/CFS and behavorial interventions justified by these models, (CBT/GET) behind us once and for all, and to shift the focus to the organical pathophysiology of ME/CFS (and depression accompanying ME/CFS), subgroups of ME/CFS patients, defined by immunological and other objective markers, and therapies to effectively reverse the biological abnormalities.
Michael Maes and Frank Twisk»
Les abstraktet til Maes og Twisk HER
Les studiet i sin helhet HER