An interdisciplinary therapeutic approach for dealing with patients attributing chronic fatigue and functional memory disorders to environmental poisoning – a pilot study

Lacour, Michael; Zunder, Thomas; Dettenkofer, Markus; Schönbeck, Sylvia; Lüdtke, Rainer; Scheidt, Carl Eduard

doi:10.1078/1438-4639-00103

Cited by 9 publications

(8 citation statements)

References 38 publications

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“…Acupuncture was considered a way to initially engage ‘stressed’ men in a treatment that is not predicated on talking about difficult emotions. This ostensibly ‘non-psychological’ entry point, while providing professional support and treatment, also allows psychological options and the relevance of referral to counselling to be explored [ 45 ]. In addition, because distressed men commonly experience somatic symptoms such as pain, insomnia, and digestive problems [ 46 , 47 ], there might be advantages in offering a physical therapy option [ 48 ].…”

Section: Introductionmentioning

confidence: 99%

How do we improve men’s mental health via primary care? An evaluation of the Atlas Men’s Well-being Pilot Programme for stressed/distressed men

2016

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BackgroundOver three-quarters of all suicides are men (England and Wales), this is despite higher levels of anxiety and depression being reported by women. This disparity may in part be explained by atypical presentations of distress in men, and gendered issues around help-seeking. Consequently, the Atlas Men’s Well-being Programme was designed to engage stressed/distressed men who were patients at a London-based GP surgery. Atlas encouraged GPs to identify and refer men for counselling and/or acupuncture by raising their awareness of men’s distress. The aim of this pilot study was to evaluate Atlas in terms of patients’ characteristics, service utilisation, patient outcomes and cost implications.MethodsAll patients using the Programme were asked to complete a questionnaire before and after their Atlas sessions. Outcome measures included the Hospital Anxiety and Depression scale, Perceived Stress Scale, Warwick-Edinburgh Mental Well-being Scale, a 11-point scale measuring physical health, and the Psychological Outcome Profiles (PSYCHLOPS), a patient-generated outcome measure. Additionally, for cost calculations, participants were asked about their employment, number of days off work due to illness, and their health and social care service use.Results102 participants were recruited, 82 completed pre- and post-treatment questionnaires. Comparisons pre- and post-treatment revealed a statistically significant improvement in anxious mood (p <0.001), perceived stress (p < 0.001), positive well-being (p = <0.001), PSYCHLOPS (p = <0.001) and physical health (p = 0.001), though not depressed mood (p = 0.660). Additionally, reductions in costs related to lost employment and health and social care use, exceeded the cost of Atlas counselling and acupuncture sessions, with an average saving of nearly £700 per patient.ConclusionsAtlas attendance was associated with improvements in patients’ mental and physical health, and demonstrated likely cost savings. It is now important to understand patient and stakeholder perspectives. Further research could compare usual care with the Atlas approach, and investigate full cost-effectiveness.

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Section: Introductionmentioning

confidence: 99%

How do we improve men’s mental health via primary care? An evaluation of the Atlas Men’s Well-being Pilot Programme for stressed/distressed men

2016

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“…There was no control group, and several confounders were not controlled for including severe mental health disorders (Hamnes et al [63]), learning disabilities (Bailey et al [45]), ability to participate [44]) or other treatments (Lacour et al [64]), which may limit the applicability of the results (Denscombe, [65]). Participants should be representative of the CFS/ME and fibromyalgia population, however as self-referrers there may be some sampling and nonresponse bias, which may limit generalisation.…”

Section: Internet Programme Plus Video Consultations With a Nutrition...mentioning

confidence: 99%

Untitled

2022

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Introduction: There are currently no disease modifying treatments for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) or fibromyalgia, and multidisciplinary therapy (MDT) is of interest. The purpose of this study was to evaluate the effectiveness of a three-month Internet MDT in the patients' homes on dietary and lifestyle behaviors, disease impact and symptoms. Methods: This was a pilot study conducted between November 2020 and March 2021, and 26 participants were recruited via advertising on UK social media. 18 participants completed the study in non-individualized Internet programme (N=12) and individualized Internet programme and video consultation (N = 6) intervention groups. The Internet programme included modules on nutrition, endocrinology, mental health, lifestyle, relationships and exercise and the individualized group received video consultations with Nutritional Therapists or Peer Counsellors in addition. Outcome measures included the Revised Fibromyalgia Impact Questionnaire (FIQR), Hospital Anxiety and Depression -Anxiety Subscale (HADS-A), the short Food Frequency Questionnaire (FFQ) and a lifestyle questionnaire.Results: After three months there were statistically significant improvements in dietary quality (p-value <0.0005), FIQR (p-value <0.014), symptom subscale (p-value < 0.006) and HADS-A (p-value < 0.041). The individualized group saw greater improvements in dietary quality (p-value > 0.04) and HADS-A (p value> 0.01) than the non-individualized group.Conclusions: This pilot study shows improvements in dietary quality, disease impact, symptoms and anxiety in CFS/ME and fibromyalgia might be found through an Internet based MDT; however possible bias exists and randomized controlled trials with a larger sample are required.

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“…Leider gibt es sehr wenige valide Therapiestudien zu MCS: Eine kleine Pilotstudie berichtete über positive Effekte eines 7 interdisziplinären Therapieansatzes (u. a. bestehend aus Information, Ernährungsberatung, Sport, Bewältigungstechniken und Akupunktur; Lacour et al 2002); kleinere Fallserien oder Kasuistiken berichten über erfolgreiche Psychotherapie oder Psychopharmakotherapiesie erlauben zwar noch keine allgemeinen Aussagen zur Wirksamkeit, belegen aber immerhin, dass 7 Psycho-und sogar Psychopharmakotherapien auch bei MCS prinzipiell durchführbar sind. Basierend auf der Annahme einer Konditionierung der Beschwerden, könnte eine 7 verhaltenstherapeutische Desensibilisierung hilfreich sein, die generelle Empfehlung einer Vermeidung ist sicher kontraproduktiv.…”

Section: Multiple Chemikaliensensitivitätunclassified

Psychosomatik der umweltbezogenen Gesundheitsstörungen

et al. 2007

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Die Umweltmedizin befasst sich mit den akuten und chronischen Auswirkungen von chemischen und physikalischen Umwelteinflüssen sowohl auf die objektiv messbare als auch auf die subjektiv wahrgenommene Gesundheit. Da die Einflüsse jedoch sehr komplex, stetig wechselnd und experimentell nur begrenzt untersuchbar sind, sind subjektiv wahrgenommene Kausalzusammenhänge schwer zu beweisen bzw. zu widerlegen. Patienten mit umweltbezogenen Beschwerden erleben eine unmittelbare gesundheitliche Bedrohung durch weitverbreitete chemische Substanzen oder auch Strahlungen oder Felder, die häufig durch naturwissenschaftliche Verfahren nicht valide belegt werden kann. Typische Beispiele sind die generalisierte Überempfindlichkeit auf alltägliche Chemikalien bei der multiplen Chemikaliensensibilität oder die Attribuierung von Beschwerden auf Amalgam aus Zahnfüllungen. Die geschilderten Symptome sind oft vielgestaltig, unspezifischer Natur und zeigen einen hohen Grad an Überschneidungen mit dem Symptomspektrum anderer, auch primär nicht umweltbezogener unklarer Syndrome. Auf der Basis moderner psychosomatischer Konzeptualisierungen können solche unklaren umweltbezogenen Syndrome am ehesten als somatoforme Störungen betrachtet und entsprechend behandelt werden. Besonders ist dabei -neben der hohen psychischen Komorbidität -auf dysfunktionale Kognitionen, Emotionen und Verhalten und die oft massiv eingeschränkte Lebensqualität zu achten. AbstractEnvironmental medicine focuses on acute and chronic effects of chemical and physical environmental influences on health as measured objectively and perceived subjectively. Since these influences are very complex, continuously changing and only partially accessible in scientific experiments, subjective causal attributions can be difficult to prove or disprove. Patients with symptoms attributed to environmental triggers perceive health threats from commonly used chemical agents or electromagnetic radiation, frequently without objective findings. Typical examples are "multiple chemical sensitivity (MCS)", a generalized self-reported hypersensitivity towards ubiquitous chemicals, or "amalgam sensitivity", where symptoms are attributed to amalgam from dental fillings. Here, the reported symptoms are almost invariably unspecific and show a high overlap with other medically unexplained syndromes. Based on modern psychosomatic conceptualizations, many environment associated illnesses can be regarded as somatoform disorders and treated as such. Apart from a high psychiatric comorbidity, special attention should be paid to dysfunctional cognitions, emotions and behaviour, and the patient's often limited quality of life.

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An interdisciplinary therapeutic approach for dealing with patients attributing chronic fatigue and functional memory disorders to environmental poisoning – a pilot study

Cited by 9 publications

References 38 publications

How do we improve men’s mental health via primary care? An evaluation of the Atlas Men’s Well-being Pilot Programme for stressed/distressed men

How do we improve men’s mental health via primary care? An evaluation of the Atlas Men’s Well-being Pilot Programme for stressed/distressed men

Untitled

Psychosomatik der umweltbezogenen Gesundheitsstörungen

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