Jump to content
RemedySpot.com

Somatoform Disorder

Rate this topic


Guest guest

Recommended Posts

I cannot understand how someone can get it so wrong and still be practicing - this is dreadful beyond words.

JB did do us proud and the fact co-authored a book with Holford (food is better medicine than drugs) makes him aok in my view anyway.

Luv nne

Most frightening though nne is that he speaks from such a high place.....

http://www.shef.ac.uk/medicine/staff/weetman.html

Burne did us proud last Tuesday, we just have to keep up the pressure now and make changes happen. Weetman thinks he is god - he isn't.

Luv - Sheila

Link to comment
Share on other sites

I have sent the following to Professor Weetman today and I am putting this on our website so he can see we will not give up.

luv - Sheila

_______________________________________

Dear Professor Weetman,

I have not previously asked the following question, but I would be grateful for a response from you.

You stated in your article published in ‘Medscape’ and ‘Journal of Clinical Endocrinology’ “Whose Thyroid Hormone is it Anyway?” – and I quote:

"The majority of patients who demand thyroid hormone treatment for multiple symptoms, despite normal thyroid function tests, have functional somatoform disorders..."

The hypothyroid patient community finds your statement irresponsible, inaccurate and insulting.

As a mark of real concern for hypothyroid sufferers, would you please publish a follow-up article in the same journals giving your reasons for coming to this conclusion, and, at the same time, providing evidence and appropriate references? I feel you have a responsibility to sufferers of thyroid disease, as well as workers in related medical fields, to provide a reliable and irrefutable explanation for your opinion.

I noted on Shomon’s About.com/Thyroid Forum http://thyroid.about.com/od/newscontroversies/a/weetman_4.htm that you responded to her articles as follows:

Sorry but you have missed at least one crucial point - somatoform disorders are neither hypochondriacal nor psychiatric - I make the point that future research will show that there is basis for these that currently eludes us.

Will you give evidence and appropriate references regarding your “one crucial point” suggesting “somatoform disorders are neither hypochondriacal nor psychiatric”. Would you also please explain how you conclude that “future research” will be done to show such a basis, as well as giving me your interpretation of somatoform disorder?

Kind regards

Sheila

www.tpa-uk.org.uk

Link to comment
Share on other sites

Interestingly though nne, it wouldnt have been considered a somatoform disorder in say, US, Germany etc but would be considered hypothyroidism - how does weetman respond to that? Im sure he will come up with some other drivvle, possibly that its completely different populations (how so I would like to know when all white americans have ancestry in other countries - such as the UK where the TSH range is higher!!).

Gill

That is brilliant Sheila, I want to know if I had Somatoform Disorder for all of those years that I felt under par

Internal Virus Database is out-of-date.Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.17.6/1192 - Release Date: 21/12/07 13:17

Link to comment
Share on other sites

Oh I do hope so - wouldnt it be nice to see him sitting in the chair that Dr Skinner so recently evacuated!!

No matter how he responded Gill, I am sure that 99% of the population will soon be able to think as we on the group do, that he talks from a place that he spends a lot of time sitting on!!!

Luv nne

..

Internal Virus Database is out-of-date.Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.17.6/1192 - Release Date: 21/12/07 13:17

Link to comment
Share on other sites

Brilliant mail, Sheila :o) Wonder if he will reply ......

Since dear Prof. Weetman states :

"The majority of patients who demand thyroid hormone treatment for multiple symptoms, despite normal thyroid function tests, have functional somatoform disorders..."

and Wikipedia enlarges:

A diagnosis of a somatoform disorder implies that psychological factors are a large contributor to the symptoms' onset, severity and duration. It is important to note that somatoform disorders are not the result of conscious malingering or factitious disorders.

There can only be one logical conclusion:

The majority of patients (who demand thyroid hormone treatment for multiple symptoms despite normal thyroid function tests) are basket cases !! - Why doesn't this pompous excuse for a doctor call a spade a spade? Oh, sorry... forgot - he's muuuch to educated for plain speech ....

Right, that's it - where are the doll and the needles ......

Love,

xx

Link to comment
Share on other sites

i'VE GOT BOTH THE DOLL AND THE VERY LONG NEEDLE ...

Luv - Sheila

There can only be one logical conclusion:

The majority of patients (who demand thyroid hormone treatment for multiple symptoms despite normal thyroid function tests) are basket cases !! - Why doesn't this pompous excuse for a doctor call a spade a spade? Oh, sorry... forgot - he's muuuch to educated for plain speech ....

Right, that's it - where are the doll and the needles ......

Love,

xx

No virus found in this incoming message.Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.19.2/1221 - Release Date: 12/01/2008 14:04

Link to comment
Share on other sites

And Ive some wax and a box of pins!!!

Re: Re: Somatoform Disorder

i'VE GOT BOTH THE DOLL AND THE VERY LONG NEEDLE ...

Luv - Sheila

There can only be one logical conclusion:

The majority of patients (who demand thyroid hormone treatment for multiple symptoms despite normal thyroid function tests) are basket cases !! - Why doesn't this pompous excuse for a doctor call a spade a spade? Oh, sorry... forgot - he's muuuch to educated for plain speech ....

Right, that's it - where are the doll and the needles ......

Love,

xx

No virus found in this incoming message.Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.19.2/1221 - Release Date: 12/01/2008 14:04

Internal Virus Database is out-of-date.Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.17.6/1192 - Release Date: 21/12/07 13:17

Link to comment
Share on other sites

Very good Sheila.

A pity you didn't make the point that nobody can foretell the future. That is not a scientific comment. You too could say that future research will show he is wrong.

>>>>I make the point that future research will show <<<<

Lilian

Link to comment
Share on other sites

Maybe you have hit the nail on the head there Gill. He might be suffering from something like the narcissistic condition (cannot remember its name).

I think Sheila had a list of symptoms of that disorder. I wonder if many of them fit ;)

Lilian

Of course he might think he can - as a result of a somatoform disorder!!

Link to comment
Share on other sites

***I think Sheila had a list of symptoms of that disorder. I wonder if many of them fit ;)

NPD - Narcissistic Personality Disorder ...... - oh, they do fit all right - quoting :

Narcissists work hard to distort our reality to make their reality feel safer.....

Disordered people aren't just hurtful. They also spin our reality to make theirs less painful. They project their problems onto us, and blame us for what they do. After a while it becomes hard to distinguish what is real from what is being projected and what is being distorted. We begin to doubt our reality and question whether we're the crazy ones. What's more, disordered people hide their problems very effectively, concealing their disease from most people, causing us further confusion.....

sound familiar?

love,

xx

Link to comment
Share on other sites

“There is a principle which is a bar against all information, which is proof against all arguments and which cannot fail to keep a man in everlasting ignorance—that principle is contempt prior to investigation.”

HERBERT SPENCER

Another quote which might appertain to certain doctors.

Link to comment
Share on other sites

  • 2 years later...
Guest guest

I think will have something to say about this diagnosis. Functional

Somatoform disorder should be diagnosed ONLY when all other possible causes for

the symptoms have been eliminated. In the case of the symptoms of

hypothyroidism still being complained about by patients who have normal thyroid

function tests, or they are being treated for hypothyroidism with levothyroxine

only, doctors are NOT testing to find out whether the thyroid hormone being

secreted by the thyroid gland (which may be normal) is actually getting into

the cells. Until such tests are carried out, and it can be shown that the NHS

have properly tested to show there is sufficient thyroid hormone in the tissues

and cells, they should NEVER give a diagnosis of functional somatoform

disorder.

Where have I heard his very last suggestion before "

Consider antidepressants " - there is evidence that SSRIs can be effective.

It seems this is the FIRST thing NHS GP's consider if your

thyroid function tests are 'normal'

Sheila

I

saw this posted on an ME forum. It's recent advice given to NHS GPs in how to

deal with patients with Somatoform Disorder (you know the one Weetman thinks we

all suffer from!!).

If your GP starts using any of these tactics on

you, you'll know where the conversation is heading.....

Managing medically unexplained symptoms

07 Apr 10

Dr Mark on how a psychological model for dealing with somatoform

disorder can be used in primary care

It can seem burdensome when a patient repeatedly presents with physical

symptoms and requests for investigations, despite repeated negative findings

and reassurances that the symptoms have no physical basis.

Somatisation disorder is a form of this state of affairs where the main

features are multiple, recurrent and frequently changing physical symptoms

†" as opposed to hypochondriacal disorder where the essential feature is

a persistent preoccupation with the possibility of having one or more serious

and progressive physical disorders.

Dissociative (conversion) disorder is a less common presentation, presumed

to be psychogenic in origin, being associated closely in time with traumatic

events, insoluble and intolerable problems, or disturbed relationships. There

is little evidence-based treatment of conversion disorder.

The approach

The Extended Reattribution and Management Model was developed for managing

somatoform disorders (1) and I have adapted the model to complement my

experience as a GP.

Make the patient feel heard and understood

One of the most important psychological aspects of the programme is to make

the patient feel heard and understood †" using the OARS approach.

• Open questions †" what, where, how, why... Closed questions lead

to the doctor overcontrolling the conversation. Balance open questioning with

keeping focused. Such patients typically elaborate greatly on how severe an

impact symptoms are having on their lives and often go off topic.

• Affirmations †" such as saying: ‘Yes, clearly this has been

taking its toll on your relationship, so how does . . .?’

• Reflective listening

• Summarising †" such as: ‘If I have understood you correctly, you

are saying...’

Working like this will reduce patient resistance to the idea there is

nothing seriously wrong and that investigations and treatment are unnecessary.

Explore life events, stress and other external factors

Ask the patient:

• What else is happening in your life in general?

• How do you feel about this?

• What causes you the most trouble?

Ask about depression and anxiety

Ask about psychosocial circumstances and relationships at the beginning, otherwise

the patient may feel that you are trying to dismiss the symptoms as being

‘all in the mind’ as you cannot find anything else wrong.

We need to help our patients accept that we are psychobiological in nature.

They have symptoms that are real and have a need to deal with them whatever the

cause.

Somatisers may actually be biologically different. Research suggests that

somatising patients lack a normal filter function, resulting in the patients

being unable to ignore irrelevant stimuli.

Be clear about the patient’s ideas, concerns and expectations.

Remember to ask what the patient thinks might be going on, what they are

worried about and what they think should be done and why.

Brief, focused physical examination and indicated investigations

For example, listening to heart sounds if the patient complains of ‘heart

trouble’ †" saying: ‘Nothing in your description makes me think there

may be something wrong with your heart, but I would like to listen anyway.’

This reassures the patient that they are being taken seriously and you are

being careful and meticulous.

Be clear about the diagnosis †" if you have one †" and that

there is nothing medically serious or sinister going on.

A patient is most likely to accept this if you show that you have an

understanding of the condition they are worried about and have discussed the

absence of related symptoms and signs. Never tell the patient there is nothing

wrong with them.

Acknowledge the reality of the symptoms and communicate empathic

understanding of the patient’s emotional problems or statements.

For example, tell the patient: ‘I can see you are very troubled by your

symptoms. Fortunately, for your reassurance, I can tell you that nothing

indicates a serious physical disease. Perhaps we could try together to look for

other possible explanations for your pain.’

Discuss the limitations of medicine

Explain we are unable to diagnose a large number of the problems people

bring to the surgery. We can exclude serious pathology. Many of these

undiagnosed problems then just get better. When the problem does not completely

go away, it is possible to learn to manage them better.

Roll with resistance

You may find in the more severe cases that there is a long way to go before

the patient can begin accepting that there is nothing seriously wrong. Maintain

the empathic, firm-but-friendly approach. For instance:

‘I can see you are convinced you have heart trouble but I can find no

signs of changes to your heart, which is why we cannot offer surgical or

medical treatment that will make the symptoms go away. On the other hand, there

are several things you can do to feel better, which would also be the case if

you did suffer from an actual heart condition. Would it be okay to take a

closer look at these?’

Address the mind-body link

Try to explain that tension or mental stress is commonly accompanied by

physical symptoms and/or that it may worsen existing physical symptoms.

Examples you could use include:

• palpitations, breathlessness, and other physical symptoms when

frightened or nervous

• increased sensitivity to physical symptoms when depressed

• tightening of muscles when frightened or stressed.

The chronic, entrenched patient

It may be helpful to tell the patient: ‘Many people feel like you do. It

is in no way a rare condition †" in fact we have a name for it,

somatisation.’

Explain that the fundamental cause is unknown, as is also the case for many

other illnesses, such as essential hypertension.

Assist the patient’s understanding by using well-known examples such as

when you think about fleas and lice, you start itching.

Furthermore, it could also be mentioned that it can run in the family.

Explain to the patient that how they act and react to symptoms is important

for their future well-being. The patient must learn how to cope with illness,

that is, to function as well as possible in spite of the trouble he or she is

experiencing and that it is important not to become physically unfit, which

will just make things worse.

It is also important for the patient to understand that he or she should not

expose him or herself to unnecessary tests or treatments because this may cause

harm.

Future involvement for the chronic, entrenched

• Be proactive not reactive.

• Promote continuity; become the named practitioner for the patient and

inform other medical colleagues.

• Book regular scheduled appointments. You may not want to see them again,

but this is an investment as you will see them less and save time in the long

run.

• Acknowledge symptoms and their impact.

• Explore provoking and relieving factors; encourage more elaboration of

relieving factors and influences and summarise with emphasis on what is

working.

• Explore and encourage elaboration of how the patient is coping despite

the symptoms.

• Consider antidepressants †" there is evidence that SSRIs can be

effective.

http://www.pulsetoday.co.uk/story.asp?sectioncode=50 & storycode=4125656

No virus

found in this incoming message.

Checked by AVG - www.avg.com

Version: 8.5.437 / Virus Database: 271.1.1/2803 - Release Date: 04/13/10

20:22:00

Link to comment
Share on other sites

Guest guest

Hello Sheila, what has J.Burne written and is there a link? I missed this.

Thanks,

Louise.

>

> Most frightening though nne is that he speaks from such a high place.....

>

> http://www.shef.ac.uk/medicine/staff/weetman.html

>

> I understand also that he is on the editorial staff of every medical journal,

so is in a position to decide what research should be published and what should

not. He is also head of medical schools - and this is where the teaching of

hypothyroidism is so appalling. Burne did us proud last Tuesday, we just

have to keep up the pressure now and make changes happen. Weetman thinks he is

god - he isn't.

>

> Luv - Sheila

Link to comment
Share on other sites

Guest guest

Wow Louise, you are going back some. That was an article (double

page spread) that Burne (freelance Medical Writer) wrote in the Daily Mail

after Dr Skinner's Fitness to Practice Hearing at the GNC. He really told our

story as it is and what we have to put up with and the reason why those failed

by the NHS diagnosing and treatment protocol had no choice but to find Doctors

such as Dr Skinner to get back their health. There must be a link to that

somewhere, but off the top of my head I can't think where it would be.

Burne also wrote another article about a year back and interviewed

me for about 3 hours one evening - I felt that I had written the article in the

end. presented it to the Editor of the Daily Mail who read it and

promised to publish it but it never got published - somebody, somewhere put a

stop to that. It is practically IMPOSSIBLE to get anything about thyroid

published unless it is from famous people who had all the symptoms, went to

their doctor, had the thyroid function tests, found to be outside the normal

reference range, given the little white pill levothyroxine and lived happily

ever after. All their stories have happy endings - unlike those who never get

diagnosed because their TFT's are within the normal range, or those who have

been diagnosed and cannot convert the inactive T4 to the active thyroid hormone

T3. They will now not publish such stories from these folk, because the Royal

College of Physicians tells the editors this is not the case, and such patients

are suffering from functional somatoform disorder - meaning, its all in their

head. Therefore - no story. When Editors ask Weetman to comment, he comments as

HEAD OF ALL UK MEDICAL SCHOOLS and DEAN OF SHEFFIELD UNIVERSITY. So - who is

the editor to believe, the patient who's symptoms are 'all in their head' or

the RCP and AP?

Luv - Sheila

Hello Sheila, what has J.Burne written and is

there a link? I missed this.

Thanks,

Louise.

>

> Most frightening though nne is that he speaks from such a high

place.....

>

> http://www.shef.ac.uk/medicine/staff/weetman.html

>

> I understand also that he is on the editorial staff of every medical

journal, so is in a position to decide what research should be published and

what should not. He is also head of medical schools - and this is where the

teaching of hypothyroidism is so appalling. Burne did us proud last

Tuesday, we just have to keep up the pressure now and make changes happen.

Weetman thinks he is god - he isn't.

>

> Luv - Sheila

No virus

found in this incoming message.

Checked by AVG - www.avg.com

Version: 8.5.437 / Virus Database: 271.1.1/2803 - Release Date: 04/13/10

20:22:00

Link to comment
Share on other sites

Guest guest

Hello Sheila, I think I remember this now, although I don't think I ever got to

read it.

I wish there was some way we could get an unbiased story, or several, published

in mainstream papers/magazines but I think most of them must have been got at

:0(

Louise.

>

> Wow Louise, you are going back some. That was an article (double page

> spread) that Burne (freelance Medical Writer) wrote in the Daily Mail

> after Dr Skinner's Fitness to Practice Hearing at the GNC. He really told

> our story as it is and what we have to put up with and the reason why those

> failed by the NHS diagnosing and treatment protocol had no choice but to

> find Doctors such as Dr Skinner to get back their health. There must be a

> link to that somewhere, but off the top of my head I can't think where it

> would be.

>

> Burne also wrote another article about a year back and interviewed me

> for about 3 hours one evening - I felt that I had written the article in the

> end. presented it to the Editor of the Daily Mail who read it and

> promised to publish it but it never got published - somebody, somewhere put

> a stop to that. It is practically IMPOSSIBLE to get anything about thyroid

> published unless it is from famous people who had all the symptoms, went to

> their doctor, had the thyroid function tests, found to be outside the normal

> reference range, given the little white pill levothyroxine and lived happily

> ever after. All their stories have happy endings - unlike those who never

> get diagnosed because their TFT's are within the normal range, or those who

> have been diagnosed and cannot convert the inactive T4 to the active thyroid

> hormone T3. They will now not publish such stories from these folk, because

> the Royal College of Physicians tells the editors this is not the case, and

> such patients are suffering from functional somatoform disorder - meaning,

> its all in their head. Therefore - no story. When Editors ask Weetman to

> comment, he comments as HEAD OF ALL UK MEDICAL SCHOOLS and DEAN OF SHEFFIELD

> UNIVERSITY. So - who is the editor to believe, the patient who's symptoms

> are 'all in their head' or the RCP and AP?

>

> Luv - Sheila

>

>

>

> Hello Sheila, what has J.Burne written and is there a link? I missed this.

>

> Thanks,

> Louise.

Link to comment
Share on other sites

Guest guest

Was it this article?

http://www.dailymail.co.uk/health/article-506717/The-wake-pill--controversial-th\

yroid-supplement-help-tiredness.html

Jerome Burne, not ?

>

> Wow Louise, you are going back some. That was an article (double page

> spread) that Burne (freelance Medical Writer) wrote in the Daily Mail

> after Dr Skinner's Fitness to Practice Hearing at the GNC. [...] ********There

must be a

> link to that somewhere, but off the top of my head I can't think where it

> would be. *****

>

> Hello Sheila, what has J.Burne written and is there a link? I missed this.

>

> Thanks,

> Louise.

>

> --- In thyroid treatment

Link to comment
Share on other sites

Guest guest

That's it - thanks so much for finding it. I remember how

delighted I was to see Thyroid Patient Advocacy had been put as the first

contact if anybody needed more information, with the British Thyroid

Association behind me - Oh - how I did enjoy that ;o)

Was it this article? http://www.dailymail.co.uk/health/article-506717/The-wake-pill--controversial-thyroid-supplement-help-tiredness.html

Jerome Burne, not ?

>

> Wow Louise, you are going back some. That was an article (double page

> spread) that Burne (freelance Medical Writer) wrote in the Daily

Mail

> after Dr Skinner's Fitness to Practice Hearing at the GNC. [...]

********There must be a

> link to that somewhere, but off the top of my head I can't think where it

> would be. *****

>

> Hello Sheila, what has J.Burne written and is there a link? I missed this.

>

> Thanks,

> Louise.

>

> --- In thyroid treatment

No virus

found in this incoming message.

Checked by AVG - www.avg.com

Version: 8.5.437 / Virus Database: 271.1.1/2803 - Release Date: 04/13/10

20:22:00

Link to comment
Share on other sites

Join the conversation

You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
×
×
  • Create New...