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Mitochondrial dysfunction test

SW,

Just in case you miss it, please note my comment on Talk:CFS Mitochondrial dysfunction test. I did feel that your criticisms of SM and JMH were unfair and unwarranted, but on reflection I regret my personal dig and I apologise. I am not sure what the protocol is on editing your own comments here, but anyway should have the right to reply. TerryE (talk) 18:31, 1 February 2009 (UTC)

No problem. My reply to your comment wasn't entirely constructive either. If you want we can delete them both, but it doesn't really bother me either way. I don't really have an opinion on the Mitochondrial dysfunction test itself - it may or may not have merit, and I would be very glad if an unambiguous test for CFS was developed. It just seems unlikely that it would come from these people. They seem to be more interested in proving that CFS is not psychiatric, even though their research doesn't actually do that. --sciencewatcher (talk) 20:07, 1 February 2009 (UTC)

I still think that your response is unfair. The paper in the IJCEM is a serious piece of work, albeit experimental. OK, I am biased here. I went down with bad CFS a year ago, and I am now at the point where I can walk for maybe 100-200m before my legs buckle. The myalgia no longer locks my body solid, and I've got it under control. I can now think straight if I stay prone. I can tolerate being driven for maybe 15 mins. Yet if I push my body's invisible limits then what stamina I have can be trashed for up to 2 weeks, and my cognitive coherence shot to ribbons.

That's the problem with this debate. Structured learning might well help recovery for marginal CFS suffers (I don't discount the powers of neuro-plasticity), but for those that unable to sit up for more than a couple of hours without being totally exhausted, it is simply irrelevant. My energy system simply does not work effectively. Telling me that it's a psychosomatic manifestation is just a joke. I took these test and they showed me at the extremes of her mitochondrial scale. I come back to simple facts: this sort of outcome isn't psychiatric. With these findings it's either a lab based valid biological discriminant, or a gross fraud on part of NEB and JMH. The NHS and my GP have only one treatment on offer: CBT — assuming that I could survive the 2hr round-trip to the daycare centre where this is offered. According to the NICE guidelines any other diagnosis or treatment is classified as not cost-effective. :lol:

What I don't understand is why CBT/GET advocates don't tout it for cancer and other diseases. I suspect that ten years ago you would have been calling Peptic ulcers stress related and therefore psychosomatic, and Warren and Marshall frauds for their work on H. Pylori. — TerryE (talk) 22:13, 1 February 2009 (UTC)

Well I was in the same position as you a number of years ago, but I caught it early and recovered. Psychiatric explanation seems the most logical, both from my own experience, talking to other people who have recovered, and also looking at the research. But I don't have any fixed POV and if someone could show that my CFS was actually caused by some virus or mito dysfunction it wouldn't bother my one way or another. Bear in mind that stress and burnout significantly alter the HPA axis, which is the body's energy system, and therefore psychiatric factors do indeed change mitochondrial function.

Anyway, the bottom line is that even if the mito dysfunction test is valid, it doesn't say what the cause of the dysfunction is. It could be psychiatric, it might be something else. But using this research to prove that CFS is a "physical" illness means you don't really understand how the body works. And I'm not having a dig at you personally here, the entire CFS patient population seems to have the same incorrect notions. My own view about CBT is that it isn't these f*ed up notions that cause CFS, but they CAN prvent you recovering. I was very open minded about my illness and I wasn't afraid to consider all possibilities. My guess is that CBT helps patients by giving them information about the etiology of the illness (how psychiatric factors can cause physical illness), and also encouraging them to gradually build up physical and mental activity rather than either doing nothing or doing too much and then relapsing (i.e. pacing). Obviously if you are severely ill you can't really go to a clinic, and in the UK they are doing research into nurses providing home based care for severely affected patients.

Oh, and ulcers are still caused by stress. Virtually everyone has H.Pylori but it doesn't cause ulcers, and research shows that stress is the most important factor in people who develop ulcers. Have a look at the stress info on the Peptic ulcer page.

You basically seem to be saying that there is no such thing as psychosomatic illness. But think for a moment about how the body works: cortisol and adrenaline, the two main stress hormones, are also the main modulators of the immune system. So mental stress causes reduced immunity, and this isn't just some theory dreamt up by psychiatrists - you can demonstrate it in the lab. --sciencewatcher (talk) 23:56, 1 February 2009 (UTC)

SW, Thank-you for your considered response. I don't think our perspectives are actually that far apart. Of course stress, disturbances to the HPA axis and the impact of long term cortisol and adrenaline levels are major factors in both raising one's susceptibility to illness, including those which give rise to CFS. I am sure that stress / burn-out were major factors in my collapse in health. Yes, (positive) mental attitude with sensible goal setting is important in managing this illness, and without these you just won't recover IMHO. Yes, many people can't find the mental wherewithal to do this on their own, and in such cases timely counselling assistance and CBT can have a measurable benefit. So it's an effective tool for some classes of patient in some phases of recovery management, and by and large that's what the studies show.

However, returning to the pectic ulcer analogy: yes, stress is a major factor in why X succumbs to the illness and Y doesn't, but removing the stress doesn't cure the ulcer; in general a course of combination antibiotics will. The problem with CBT for most acute CFS patients is that it is positioned as the "only effective treatment", therefore no funding is available to biomedical research into CFS; no detailed diagnosis, and no alternative treatments are available. I don't regard CFS as an illness per se; it's a syndrome classifying a bodily failure mode that could be due to any one of a number of causes. However, biological treatments are often specific to the illness, and therefore will have variable benefits across a CFS patient spectrum.

There have been roughly 300,000 words in the CFS talk pages and a large part if not the majority of this debate has been around this CBT issue. Various experts and reputable research papers have been cited supporting the existence of this debate, yet whenever a simple statement is added to the effect that the efficacy of CBT (not just GET) has been challenged by some experts and patient groups, this gets reverted by a CBT proponent. Sad. -- TerryE (talk) 02:12, 2 February 2009 (UTC)

My opinion is slightly different from yours I think...you seem to think that stress can be a trigger for CFS which then lets a virus (or whatever) take hold and it is the virus that actually causes the illness (or maybe something else). My view is that stress is the major factor in and of itself. Unlike peptic ulcers or an infection that gets worse because of stress, all of the signs and symptoms of CFS seem to be symptoms of stress itself rather than anything else. But that's just my educated opinion on the matter. As for CBT, I completely agree with you there - we shouldn't be over-hyping it in the article like some people want to do. Equally we shouldn't be trying to remove all reference to it. We really need to just reflect what the major reviews say about the effectiveness of it, and that's what I've been trying to do. There has been an awful lot of research into the biological nature of CFS, but not much has been discovered that has been useful in actually diagnosing patients, treating them, or understanding the etiology. Even though the evidence is low quality, CBT is the only treatment that has been shown to be effecive at all in treating CFS. So I do understand patients wanting to try alternative treatments, and doctors like S.Myhill and others offering experimental treatments, but I think they are just giving patients false hope and they are actually hindering recovery by telling patients to ignore psychiatric factors/treatments. --sciencewatcher (talk) 02:34, 2 February 2009 (UTC)

Regarding the statements that "stress is the most significant factor in peptic ulcers" and "virtually everyone has H pylori, but it doesn't cause ulcers", the Wikipedia articles on Peptic ulcer and Helicobacter pylori don't say that at all (look at the "Epidemiology" section of the latter article too). By "research shows" I'm assuming you mean that single study from Thailand? Whereas having a quick look on PubMed, these reviews seem to suggest otherwise (even the first pro-biopsychosocial one which states that "Psychosocial factors can be estimated to contribute to 30% to 65% of ulcers..." and the full-text is freely accessible) : [ PMID 10772394 | PMID 16456574 | PMID 12492176 | PMID 16581366 | PMID 10633828 | PMID 18537633 | PMID 8590166 ].

Anyway, as for CFS, I think it's a matter of degree rather than black/white, but the fact that psychological factors influence other biological states doesn't mean much for CFS unless it's demonstrated to be specific to CFS. I understand that many people don't have a good awareness of the complex interaction between the traditional notions of mind and body; however, just as problematic is how this general interaction is often used to justify over-simplified mind-body ideology, which can lead to sloppiness when trying to connect the dots (I have been guilty of this in the past). There are already enough conceptual and methodological problems in CFS research.

While I disagree with the impression from some people that CFS is definitely an incurable virtually-neurodegenerative disease where psychological factors are essentially impossible or rare, the "biopsychosocial" approach itself (something I used to support) is being overstated too, at least the universalness of it. It makes sense that in an illness where stresses can make symptoms worse, psychological factors can therefore affect the prognosis; but a problem with viewing CFS as a classic "stress-disorder" is that a rather large proportion of patients don't seem to experience significant "stress" prior/during onset, don't have the relevant psychological profile, and don't necessarily respond to reduction or removal of internal/external stresses. This is like diagnosing major depression without anhedonia and negative thoughts/mood, diagnosing MS without white matter lesions, etc.

It may be inappropriate to dismiss the possibility of psychological factors in CFS, but it seems just as inappropriate to deny the possibility that psychological factors can contribute to a physiological state that isn't necessarily readily treatable with psychological intervention. The grey-area inbetween "psychiatric vs organic" means exactly that, it doesn't mean "inbetween, but still a mental illness". If not purely organic in the etiological sense, a true middle ground is what is needed, rather than revamped psychiatry. - Tekaphor (TALK) 09:12, 2 February 2009 (UTC)

[outdent] SW (and now Tekaphor) I just wanted to thank you for the opportunity to have a rational discussion about this. Even though our views differ in some areas, I do value a considered challenge to my thinking. I've been pretty much flat on my back for 12 months now, and I've had more to think about in this discussion than anything that the UK NHS has offered me. I also know from person experience that the "CBT is the only effective treatment" can be dangerous. A friend had serious recurring ME for over a decade, and all she was offered was psychiatric counselling. She eventually managed to get referred to another consultant privately who did a fresh set of tests because he suspected Lyme disease and she tested positive for one of the Borrelia strains. Unfortunately on a follow up after the antibiotic treatment she also tested positive for leukaemia and she was dead 9 months later. Whether or not the Lyme disease (or its treatment) was a factor in her leukaemia, her quality of life in her last ten years would have been a lot better with early treatment of the Borrelia.

My view is that currently the body's internal repair system is the only real available 'treatment'. What I can do to assist here is to attempt to address the psychological, environmental and dietary stress factors that might degrade or inhibit this process. In the case of possible mito functional damage, I suspect that cell division is the best repair mechanism, which is maybe why suffers with a myalgic focus to their symptoms tend to improve over the longer term (in contrast to those with a neurological focus). So yes, I take various supplements, FIR saunas, etc.. No I don't have any faith in any of these; just more of a precautionary principle: there is a plausible argument that they might help, and there are minimal risks in doing so. My only way of experimenting are longitudinal studies on one subject: me. B12 injections have a very noticeable effect on my concentration abilities, and reducing my tinnitus, and hene quality of life. I also take magnesium injections because again, if I stop, I notice the drop in stamina and more noticeably recovery time after exertion (like sitting in my kitchen to have a meal).

Thanks again. I will stop taking up your personal time. Maybe if you need advice on website construction, VirtualBox/virtualisation, or OpenOffice.org (where I act as an expert / administrator) then I can return the favour :-) -- TerryE (talk) 01:38, 3 February 2009 (UTC)

Replied to TerryE by email. --sciencewatcher (talk) 22:10, 4 February 2009 (UTC)

Reversed burden of proof problem - help needed

I wonder if you are able to comment on the following principle, relevant to the Ayn Rand dispute - see the talk page, and see WP:Requests_for_arbitration/Ayn_Rand. The problem is as follows: William Vallicella, who is a recognised Kant scholar, has published something in a blog post about Rand having completely misunderstood Kant. Someone has objected that while Vallicella is a recognised Kant scholar, he has not published on Rand in reliable sources (a blog post not being considered RS), and so the citation cannot be allowed.

This is the reverse burden of proof problem - it is hard to find scientific sources that discuss pseudoscience. In such cases I believe it is legitimate to source from non-promotional descriptions of pseudoscience that can only be obtained from second- and third-party sources and not peer-reviewed.

The dispute also has affinities with the special pleading problem - that pseudoscientists (or in this case, pseudoacademics) can object that the academics are not expert in the pseudoacademic subject. This is of course an absurd argument, and if allowed unchallenged, would open the floodgate - any advocate of any fringe view could object that the advocates of scientific method simply didn't understand the pseudoscientific 'theory' being advanced.

I appreciate you are not an expert on philosophy (at least I assume not). But this has little to do with philosophy, and everything to do with the need to establish a precedent in Wikipedia policy. Because science is generally silent about pseudoscience, it is difficult to reliably source scientific views on pseudoscience. In such a case, we should be allowed to source views of established scientists or academics or scholars, from any available sources (giving precedence to reliable independent sources where possible).

Principle: if an established scientist, scholar or academic has made statements about a pseudoscientific or pseudo-academic subject, then whatever the source of that statement, it should be allowed as a reliable source, if no other sources are available. Peter Damian (talk) 12:40, 14 February 2009 (UTC)

I have no idea who Ayn Rand is, and I know practically nothing about philosophy. My only suggestion is that you take this to the reliable sources noticeboard. Websites can be reliable sources: for example, quackwatch has been deemed a reliable source. Also, opinions can be reliable sources, and I don't think it matters where the opinion is published as long as the opinion is from a recognised expert. Unless there is some wikipedia policy that says blogs can't be reliable sources, then it should be ok for an opinion. But I'm not an expert in wikipedia policy so I could be wrong. --sciencewatcher (talk) 16:40, 14 February 2009 (UTC)

Thinking about this a bit more, I think the only issue would be the reliability of the blog. Does it fairly represent the opinion of the expert? If the blog is published by the expert himself in his own blog you should be ok. Or if it is the blog of a newspaper such as The Times. But if it is just the blog of some random nobody then it's probably not a reliable source - how can you be sure they haven't just made up the comment or grossly misrepresented it? Again, your best bet is to ask on the reliable sources noticeboard and you'll get a better answer than I can give you. --sciencewatcher (talk) 17:01, 14 February 2009 (UTC)

thanks there has been some discussion of this (see my edit trail) and your point of view - i.e. that if the blog writer is a reliable source, and if what he is writing about is the same as what he is regarded as reliable for (some scientists who are reliable on one subject are notoriously unreliable on others) then it is OK. Peter Damian (talk) 21:16, 14 February 2009 (UTC)

Naturopathy

Sciencewatcher; I changed the wording on the naturopathy article again because there are scientific techniques practiced by naturopaths, such as nutritional counseling and vitamin/mineral supplement advice. If that's not considered scientific, then dieticians would also be considered "unscientific" and they are regularly employed by hospitals across the country. —Preceding unsigned comment added by Wintersdoor (talk • contribs) 19:13, 16 February 2009 (UTC)

I never claimed that all things practised by naturopaths are unscientific, just some. But some of the nutritional/vitamin advice practised by naturopaths is done in a pseudoscientific way, e.g. (as happened with a friend of mine recently), being told that your fibromyalgia is caused by an intolerance to red meat, which is obvious bullshit. Anyway, your change seems reasonable. --sciencewatcher (talk) 19:40, 16 February 2009 (UTC)

I'm glad you think my change is reasonable - as you and I have had something of a debate over this section, I would really appreciate it if you would back me up on the Discussion page for the article - I've met with some resistance to the change and I think it's very reasonable, all things considered —Preceding unsigned comment added by Wintersdoor (talk • contribs) 21:03, 16 February 2009 (UTC)

PMID 16957679

Send me an email and I will reply with the pdf attached. Xasodfuih (talk) 03:42, 24 February 2009 (UTC)

Actually, I found it on a website. --sciencewatcher (talk) 15:00, 27 February 2009 (UTC)

Essential fatty acids ref

Thanks for the offer, you can send it to GmaleW(at)gmail.com without the plus signs and sub @ for (at). Thanks again. Ward20 (talk) 02:59, 27 February 2009 (UTC)

Ok, done. You should have received 5 emails. --sciencewatcher (talk) 15:00, 27 February 2009 (UTC)

Got it, thanks. Ward20 (talk) 16:49, 27 February 2009 (UTC)

Inappropriate behavior

WARNING: Your edit "15:40, 12 February 2009 Sciencewatcher (Talk | contribs) (15,376 bytes) (Undid revision 270188962 by Anonymous081222 (talk) f off idiot) (undo)" is inappropriate.

Since when is it ok to make comments like "f off idiot"? Anonymous081222 (talk) 21:33, 27 February 2009 (UTC)

It's appropriate when some idiot (i.e. you) vandalises my talk page with an entirely bogus 3RR warning. Keep this up and you will eventually be banned. --sciencewatcher (talk) 00:28, 28 February 2009 (UTC)

Actually, the obesity info is now in both GA and MSG articles. Until I added that information, the article was one sided: it only presented the views of those who considered MSG safe. There are concerns expressed in the quoted sources that need to be presented to the reader, seeking information on the health effects, and those readers may arrive at the articles from different angles - either glutamic acid or MSG. It is safer and more ethical to keep this information in both places.

Just deleting the contributions is simply put vandalism. I am inviting Sciencewatcher to stop his/her crusade to keep the article on MSG sanitized. Please contribute the materials you consider relevant and leave other's alone. —Preceding unsigned comment added by 12.10.219.162 (talk) 19:20, 4 June 2009 (UTC)

More fun here: Wikipedia:Editor assistance/Requests#User Sciencewatcher monopolized two articles and keeps vandalizing contributions :-) Cacycle (talk) 21:18, 5 June 2009 (UTC)

Thanks for the heads up on this. --sciencewatcher (talk) 22:20, 5 June 2009 (UTC)

Emotional Freedom Technique

Have you heard of this? Very amusing. Thought you'd be interested. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:40, 13 June 2009 (UTC)

No I haven't heard of it, but reading the article it seems pretty quacky. Anything that relies on the body's "energy fields" is automatically dubious. Looks like you're doing a good job of cleaning it up. --sciencewatcher (talk) 02:10, 13 June 2009 (UTC)

Indeed. I asked TimVickers for a reprint of an article, which I believe will essentially say "now here is why it is bullshit". Sweet. WLU (t) (c) Wikipedia's rules:^simple/_complex 14:25, 13 June 2009 (UTC)

Monosodium Glutamate

You responded to a query I made: "Sorry, I didn't bother putting in a comment - I assumed it was obvious. See MastCell's comment in the glutamate article. --sciencewatcher (talk) 14:13, 29 June 2009 (UTC)" Being new to Wikipedia, I don't know how to find MastCell's comment in the glutamate article. What article would that be, and where in the article would I find his/her comment?Truthinlabeling (talk) 16:05, 29 June 2009 (UTC)

It is here ("(serious problems with sourcing, original synthesis, and undue weight)").

I would strongly suggest you read through all of the wikipedia policies before making major changes like this. You seem to have an interest in the subject, and you can make valuable contributions if you follow wikipedia policies (WP:RS, WP:Undue, etc). --sciencewatcher (talk) 18:17, 29 June 2009 (UTC)

I had read through a great deal of Wikipedia policy prior to submitting my article. I also read MastCell's comment in the glutamate article, as you suggested. And given those comments, I am not surprised that the article was pulled. Only problem is that the comments are unfounded. It’s as though someone edited my submission before MastCell read it. Following is what I wrote to MastCell.

“Did someone edit my submission to make it unacceptable before you saw it? I have a copy of what I wrote, and the words were “By that time, the fact of MSG-induced brain lesions and subsequent endocrine disorders had became undeniable, and glutamate was being used as an ablative or provocative tool to facilitate study of brain damage and endocrine disorders.” I did not say, nor would I ever say, that “the harms of MSG became undeniable” because that isn’t true. The people who profit from the manufacture and sale of MSG-containing products deny that there is harm done by MSG all the time. Next point: I did not write that independent studies proved MSG harmful. The words “prove” or “proved” were never used in my submission. And tell me please, what is wrong with saying that industry-sponsored research failed to replicate those findings when the statement is a statement of fact? I said, “There were also glutamate-industry-sponsored studies that failed to replicate Olney’s findings.” And I cited published peer reviewed journals written by those who failed to replicate Olney’s findings. I also cited a published peer-reviewed review: “In 1981, Nemeroff stated in a review of the literature that "...not one single [glutamate-industry primate] study has truly replicated the methods utilized by Olney, making evaluation of the available data impossible. Another question: What research published in the New England Journal of Medicine did I dismiss? I don’t remember dismissing any research. Dr. Kwok wrote a letter to the New England Journal of Medicine. Filer and Stegink, had an article and so did Olney et al. Please tell me what it means to “dismiss” research, and please point to the words in my submission that cause you to say I dismissed research. Last question: What is wrong with providing a list of peer-reviewed published studies for Wikipedia readers to access instead of referencing those studies individually on Wikipedia? What is the “partisan website” that you mentioned? Everything on any web site that I have used is grounded in fact. Every statement made there is verifiable. I can think of no research cited there hasn’t been published in a peer-reviewed journal. I am new to Wikipedia and I think I have something to contribute. I’m sure that my submission could be improved, but there is little or nothing in it that is either inappropriate or incorrect. I would like some serious answers to my questions.” Is there a higher authority?Truthinlabeling (talk) 23:38, 29 June 2009 (UTC)

You can't use truthinlabeling.org as a reference, because it is not a WP:RS. --sciencewatcher (talk) 23:51, 29 June 2009 (UTC)

Thanks. I'm learning the rules. There is a list of MSG adverse reactions that comes from the FDA that was scanned and is accessible through the truthinlabeling.org web site. Can I reference that FDA document?Truthinlabeling (talk) 06:51, 30 June 2009 (UTC)

Yes, that's fine. But I suspect the reference is already in the article - we already have FASEB. --sciencewatcher (talk) 14:46, 30 June 2009 (UTC)

Invitation

I invite you to assist with the expansion and sourcing of this article in the hopes that it might go live in a day or two: User:MichaelQSchmidt/sandbox/National Fibromyalgia Association. Thank you. MichaelQSchmidt (talk) 21:54, 19 July 2009 (UTC)

RfC for RetroS1mone

Strangely enough, just as RetroS1mone was naming a number of people in her recent ANI submission, I was preparing a collection of concerns for an RfC about her. I don't know if you'd be interested or not, but if you are, I'd like to invite you to edit or add to this list, which can be found here. After I've put it into proper RfC format (tomorrow, most likely) and people have had a chance to make their own contributions/edits, I will most likely submit it formally, depending on the outcome of the ANI submission. --RobinHood70 (talk) 03:06, 25 July 2009 (UTC)

RFC discussion of User:RetroS1mone

A request for comments has been filed concerning the conduct of RetroS1mone (talk · contribs). You are invited to comment on the discussion at Wikipedia:Requests for comment/RetroS1mone. -- RobinHood70 (talk) 01:32, 28 July 2009 (UTC)

I don't really have any comment, apart from the suggestion I made at Retro's talkpage. Although I've had a few issues with Retro, they have all been resolved after discussion with her. --sciencewatcher (talk) 16:54, 28 July 2009 (UTC)

While comments would certainly have been appreciated, the notice was left as a result of your comment on her talk page just to let you know that the RfC existed. Given your statements in the above-mentioned suggestion, I actually thought you might have the most balanced view of the whole thing out of all of us who regularly contribute to the CFS page (et al), since you tend to support a more psychological view, but at the same time, I think you can see the editing concerns. --RobinHood70 (talk) 22:18, 28 July 2009 (UTC)

Perhaps, but you seemed to have it under control, and I'm feeling lazy, and there wasn't actually anywhere at the rfc for me to leave a comment anyway - it says "Users not named in the request or certifying the request should post under Additional views below" but there is no "Additional views" section (only Outside view, which doesn't apply to me). Perhaps the RFC template is wrong, or perhaps I'm being too pedantic. However, as I said I don't really have the time or energy to get involved in this anyway. --sciencewatcher (talk) 23:06, 28 July 2009 (UTC)

Well, if you're being pedantic, it's no more so than I am, because I noticed that earlier today too. I'll post to the talk page about it and see if we can get that addressed. --RobinHood70 (talk) 23:14, 28 July 2009 (UTC)

Just FYI, Ward has fixed the issue on the RfC itself by adding new sections, and I've also brought up the concern at the village pump, which really just directs people to the RfC talk page discussion. --RobinHood70 (talk) 18:07, 29 July 2009 (UTC)

Ok, thanks. --sciencewatcher (talk) 19:30, 29 July 2009 (UTC)

Self-promotion

If someone invents a treatment or drug, they become associated with that treatment or drug. Or the company does, e.g. Valium and Roche. To note that pacing was devised by two professionals and didn't come falling out of the sky, or, as in the UK, it is often considered by opponents to have been developed by patients, is not self-promotion. It's clarification. I named pacing 'pacing'. You will not find it in the lit before I started to wrtie about it, around 1989. There are various versions. they need to be kept separate as oen may not be as effective as another. Jason and I have ours, very similar, APT is different. The psychiatric version described here comes from the CBT literature. Check any CBT book. As it stands, the page is promoting the CBT model and its proponents. There is no acknowledgement of the range of views and the complexity of certain issues. I sense a personal problem. Hostility. Hence my accurate work has disappeared. We're back to a lot of anecdote-based waffle.

Ellen Goudsmit —Preceding unsigned comment added by Ellengoudsmit (talk • contribs) 14:15, 8 September 2009 (UTC)

While that may be true, everything in wikipedia needs to be appropriately sourced and weighted, which didn't appear to be the case with your edits.

I actually happen to think that pacing is a very useful management tool for patients - if you check back in the edit history, you'll see that it was me who added pacing to the articles in the first place. The problem is that, for whatever reason, not much has been written about it in peer-reviewed journals.

Try this: go to pubmed, and search for "cbt cfs" (without quotes) and you'll get 34 results. Search for "cfs pacing" and you'll get 6. Also do the same thing on google scholar and you'll find that the CBT articles have hundreds of citations, whereas the pacing ones only have a handful. That is why CBT gets much more space in the article.

You should also read WP:coi regarding adding your own info to wikipedia articles. --sciencewatcher (talk) 14:28, 8 September 2009 (UTC)

There's nothing wrong with making distinctions between various forms of pacing, and I agree that there is perhaps a bias towards CBT in the current article, but we don't need to weigh down the main CFS article with a lot of technical details. If a description of various forms of pacing is needed, a sub-article can be created to go into detail with only a broad (and more neutral) description on the main CFS page.

I agree with sciencewatcher's reversions of your two recent additions in that reliable sources need to be cited when adding any kind of statement to the page that talks about certain points of view, for example the lay view or the psychiatric view. This may well be a valid description of those views, but if so, who says so?

Finally, the problem with citing your own work, as sciencewatcher suggests, is that it's not seen as citing, but rather as promoting. Even though your views and mine seem to be fairly similar, Wikipedia is nevertheless not a soapbox for espousing your viewpoints. If others believe that your work is worthy of mention, they'll mention it! By virtue of the fact that you wrote it, you inherently have a bias in terms of judging its merit and its validity, therefore you should not be the one to add your own work to an article. —RobinHood70 ^{(talk • contribs)} 18:42, 8 September 2009 (UTC)

XMVR press release information

Hello,

I'm wondering why you undid my edit to xmrv I added about the press release. This press release was issued by the publishers of the Science article referenced on the page.

Brandon.irwin (talk) 00:30, 24 October 2009 (UTC)

There have been a couple of discussions about this on the CFS talk page (here and here). The general consensus is that because the details of how that 95% was arrived at were never published, that it fails WP:RS, though other issues have been pointed out in the discussions as well. —RobinHood70 ^{(talk • contribs)} 00:49, 24 October 2009 (UTC)

Yeah, the press release is by the study authors, not by Science, so it doesn't pass the reliability criteria for inclusion. Also, doesn't anyone else think this is all a bit fishy? First they find lots of prostate cancer patients with the virus even though every other study has found nothing. And now they make their test more sensitive and they find even more patients with the virus! --sciencewatcher (talk) 20:11, 24 October 2009 (UTC)

Actually, the part I find fishy is the 95% figure (or 98, I remember reading somewhere...dunno whether that was accurate). Either way, that seems like an awfully high number for something that's thought to probably have different underlying conditions. You could argue that their inclusion criteria selected only those that likely had a viral origin, but even then, that would point to an abnormally accurate selection criteria. In any event, it's not for us to decide. While hopeful that this'll lead somewhere, I'll wait for the medical community to figure it all out. —RobinHood70 ^{(talk • contribs)} 20:34, 24 October 2009 (UTC)

labs are full of mice- so its obvious —Preceding unsigned comment added by 88.108.110.143 (talk) 22:37, 12 November 2009 (UTC)

Sw, out of interest the 1991 DeFreitas paper is open access and downloadable here. It makes interesting reading. I wonder if it is going to get revisited in the light to the recent work by Mikovits et al. I can only find one study that was CDC funded that attempted to replicate her findings, but didn't exactly follow her procedure and failed to repeat her results. The review cited this and other investigations which used diferent approaches. I expect to see more rants on the way on the article and discussion papers. I guess that its going to be another year before we get more hard peer review primary research. :-) BTW in reponse to the previous unsigned comment, the XMRV viruses were sequenced and they were XMRV and not murine viruses. -- TerryE (talk) 01:37, 15 November 2009 (UTC)

I can't seem to find the letter from DeFreitas where they say the CDC didn't use the same the same procedure, but I remember reading it before. Anyway, for wikipedia the main point is that the CDC say they couldn't replicate the results and they are a more reliable source anyway. What I would like is for the CDC to say WHY they couldn't replicate the results. For example, did the original researchers do something wrong? The CDC say they got vastly different figures when they used a modified test, so perhaps the original study didn't do exactly the same test on patients and controls? My gut says that this virus is nothing to do with CFS because there have been so many viruses implicated and at most these various viruses are probably just triggers or opportunistic infections (HHVs will always reactivate when the immune system is compromised by stress or anything else). --sciencewatcher (talk) 16:18, 15 November 2009 (UTC)

You're right. This conversation doesn't belong on the articles or their talk pages yet because allot is verbal testomony, innuendo, accusation and counter-accusation. That's why I mentioned it on your talk page because I thought that you might be interested in the background. IMHO, the fatal flaw in the scientific method is when a study area is built on an axiom set that is belief-based or politically influenced by stakeholders without undergoing fundamental validation. In this case, underpinning both CDC and NHS approaches is the implicit assumption that CFS is really a psychosomatic illness and therefore any investment in biological approaches is fundamentally a waste of money. Reeves went on record stating that he believed it unlikely that the CDC would be able to replicate the findings of the WPI XMRV study, though ironically at that time three other independent labs had already broadly done so. Watch the videos of the NIH CFSAC meeting held a couple of weeks ago where this paper and comments by independent field specialists were discussed in depth (Either Search NIH Videocasts with the key CFSAC or the Youtube playlist CFSAC XMRV 2009). Also read the DeFreitas paper. -- TerryE (talk) 19:17, 15 November 2009 (UTC)

(outdent) Sorry, just jumping into this conversation.... Three other labs have replicated these findings? I hadn't heard about this. Can you provide a specific source (just for my personal reference...doesn't have to be an RS by wiki standards). Thanks! —RobinHood70 ^{(talk • contribs)} 21:11, 15 November 2009 (UTC)

Watch extracts of the CFSAC on the above youtube playlist. I would recommend any CFS sufferer who wants to be informed about this to watch the Peterson Presentation, the Coffin viewpoint and the panel discussions. The statements were on a slide by Peterson and they were also supported by John Coffin of the NCI in his evidence so it isn't just claims from the team itself, though its definitely not RS. IIRC, the other three validations were only small groups ~20 patients, and the hit rates were lower, ~50%, but enough to validate that this isn't another Fleischmann. I expect that there will a flurry of follow-up papers in the next 3-6 months, as the WPI folk have identified a protocol for identifying both XMRV virus and antibodies in frozen and parafin block tissues samples. Also the drug companies will be seeing rolling $s in front of their eyes at the prospect of dishing out retrovirals to another 1M patients in the US and a similar number in the EU. -- TerryE (talk) 02:09, 16 November 2009 (UTC)

Seems to me lots of patients love XMRV because (using some twisted logic) it 'proves' that CFS is physical rather than psychosomatic. Reeves made valid points - he said that the researchers didn't give any info whatsoever about the sex or diagnostic criteria of the patients, and he was surprised that Science published it. How can he replicate it if they don't even give their methods? Seems to me that this is just a big dead-end waste of time and money, and pursuing this is just going to keep CFS patients sick because it's taking valuable focus away from much more likely avenues which the CFIDS Association of America (and most other so-called patient associations) simply will not consider because of their ridiculous fucking bigotry.

Sorry about the rant, but I am a former patient who nearly died from CFS and it makes me angry when the patient organisations are doing absolutely nothing to help patients, and are diverting funding and energy to dead-ends, ignoring the research, and leaving patients like me to figure this fucking thing out for ourselves. --sciencewatcher (talk) 17:14, 16 November 2009 (UTC)

Yes it is a rant, but this is your talk page. I guess where RobinHood70 and I would differ from you is that we wouldn't call ourselves former CFS patients yet. You do seem to go off the deep end when any suggestion of a biological causative mechanism for CFS is proposed. This team simply followed the trail from previously published work showing the high correlation of RNase L and incidence of CFS and the RNase L observations in previously published XMRV papers. The research cost $2M and was described as "game changing" by Coffin, as "history in the making" by Dr David Bell. The CFSAC briefing addressed Reeves points and according to Coffin, the CDC had attended a full briefing given by the team to interested research teams and agencies a month before publication. So I guess that we'll agree to differ on this one. TerryE (talk) 23:00, 16 November 2009 (UTC)

The problem is that we have been through this many times over the past 30 years or so, and every time it has turned out to be nothing. It's a bit like if, say, someone spent $2m to see if CFS was associated with being an asshole, then brought out a paper saying 'you're all just assholes'. Anyway, I guess we will just wait and see what happens (as always) and put whatever reliable research comes out into the article. --sciencewatcher (talk) 23:24, 16 November 2009 (UTC)

I agree with Terry, I'm definitely not a former CFS patient, as you well know. Your experience with CFS was clearly different than mine in many respects (which I won't go over here, since they were only discussed by private e-mail and I don't know if I still have those e-mails in any event) and has led you to believe that CFS is most likely primarily or entirely psychological in nature. I don't think you can extend that to all CFS patients, however, for the simple reason that you aren't them. :)

But returning to the topic of XMRV, I see it as potentially very significant, in that if it is, in fact, the underlying cause of CFS (and I'll be the first to say that's nowhere near definitive), it would explain a great many things about the condition, such as why there are so many differences from one patient to the next: namely that much like HIV would, it has diminished the immune system and allowed other viruses to affect the person longer and more severely than would be normal. Different co-occurring viruses would then account for the wide variety in symptoms, physical functioning and duration of the illness. Like you, however, I don't see XMRV as anything more than one theory among many at this point. I also don't see XMRV as disproving the notion that CFS is psychological. As you and I have both pointed out on several occasions, it could just as easily be an opportunistic virus taking advantage of an immune system weakened by stress. Heck, if you wanna get right down to it, this could even work in conjunction with the purely biological effects of XMRV...i.e., stress (or whatever other psychological triggering mechanism) opens the body to XMRV, XMRV opens the body to infection by other things.

I don't, however, see patient organizations as "diverting funding and energy to dead-ends". Nobody knows what causes this, and none of the research is definitive in any way. Even if CBT and GET were 100% curative, which they're clearly not, unlike the Wessely school would have us believe, that wouldn't prove a psychological cause any more than a virus proves a biological cause. So until more research can establish a cause or treatment for the vast majority of patients, including those severely affected, all theories must remain on the table until proven wrong and new theories must be developed if the existing ones don't suffice. XMRV is in exactly that category. —RobinHood70 ^{(talk • contribs)} 20:09, 17 November 2009 (UTC)

I just want to address a few points you brought up: my thoughts about CFS are not based entirely on my own experiences - I have also talked to a lot of people who have recovered and looked at the research, and stress/burnout just appears to be the best theory that explains all aspects of the illness. Some people (like you and Terry, I think) accept that stress might be a partial cause, but you believe that there must be another virus or something and the stress just lets that virus take hold. My reply to that is Occam's razor. Stress/burnout appears to explain all aspects of the illness, so why posit an unknown virus as well? As for my illness, without going into personal details here, I think my situation is very similar to Terry's (except that he hasn't recovered yet). --sciencewatcher (talk) 20:55, 17 November 2009 (UTC)

(outdent) Stress/burnout may explain the aspects of the illness for some, but not for most, I think. The style of fatigue is very different and most other aspects of the illness are not common stress-related symptoms. Regardless of that, stress played little or no factor in the illness for me personally—there was also no change in symptoms due to stress or its lack after I became ill—so I reject that as a possible reason at least in my specific case. Like you, I've spoken with others as well, and many of them had no pre-morbid stress of any kind, so I think explaining the majority of cases as stress is unrealistic, though I've certainly spoken to some people where I would place stress as a much more significant factor, and at least one where I strongly suspect the disease was in fact neuroticism or hypochondriasis. But apart from all that, I don't think the majority of research is anywhere even remotely close to saying that CFS is stress-related. Even if it was, though, that doesn't mean it's right...it used to be accepted medical fact that peptic ulcers were entirely stress-induced, but then we discovered H. pylori (though, of course, it's thought that stress can still play a role). —RobinHood70 ^{(talk • contribs)} 21:39, 17 November 2009 (UTC)

Certainly there are some people, like you Rob, who don't seem to have any significant stressors prior to the illness. So either there are two (or more) illnesses here, or else you did have stressors after all. In my own case, I didn't actually recognise any stressors until I began recovering. So if even I can't recognise my own stressors, then I'm pretty sure a lot of other people have difficulty recognising them too. There is also the fact that your celiac disease could have been a stressor. There is some evidence that viruses and vaccinations can trigger CFS, but nothing conclusive and again very confusing data. I used to think it would just be a matter of looking at cortisol levels and the HPA axis, but Cleare's studies show that the HPA axis is not affected in those people with EBV who later develop CFS. And I was searching recently for info on vaccinations and CFS - the only study I found said there wasn't really any evidence (even though Wessely, I think, found an association in Gulf War veterans).

So, what I am trying to say is that it is all very complicated, and although stress is definitely a factor for many patients (and they should be open minded about this), it may not apply to all patients and even when it is stress it still isn't always easy to figure out what to do to recover (removing the stress is generally not an option, because the stress normally has already finished by the time you get CFS).

What bothers me most is patients and patient organisations saying that the illness has NO psychological aspects whatsoever. The effect of this is twofold: firstly, they are damaging patients who do have a psychological explanation for their illness and who might have recovered given the right information. And second, it makes them look like nutballs (especially when they jump on every ridiculous theory) - basically achieving the exact opposite of what they want to achieve. --sciencewatcher (talk) 22:34, 17 November 2009 (UTC)

Yeah, I can't argue with your addendum. I know I've said before that there are patient organizations, forums, etc., where any and every wacky theory is immediately presented as credible and something that everybody should try, in case it might work for them. What bugs me most about these is that with only a few minutes of investigation, 90% of them can be seen to be somebody just trying to make a buck for themselves off our illness by selling the very products they're recommending. Biased info much? And whether the cause is biological or psychological, to me it's utterly ridiculous to say that there are no psychological aspects to the illness whatsoever. Any long-term illness has psychological aspects. Sadly, I think this has become a Catch-22, where patients freak out at the word "psychological" due to their inherent beliefs about the illness and the stigma that they face, and so are unwilling to look at any psychological aspects. Those who are presenting the psychological aspects, whether they believe it's only one aspect or the entire etymology, then present their views with more conviction just to get their point across. Patients turn around and look at this as psychologizing, and the cycle repeats. Oh joy! ;) —RobinHood70 ^{(talk • contribs)} 22:57, 17 November 2009 (UTC)

I do think that psychological stress plays big part in triggering this illness (as does immune system stress following viral infection, etc.) but I know some CFS suffers whose onset was, like rh70, without any obvious stress triggers. However as you say, sw, mental approach and positive management of energy profiles / exercise also play an incredibly important role in dealing with this illness (though I do have a problem in accepting that the rather formulaic CBT and GET methodologies are any better that other NLP based strategies, etc.). I also think that talking about GET is no use to someone who has difficulty in getting to the en-suite to have a pee and who then takes 2 hrs to recover from this 8 metre journey; these exercise therapies are really more applicable to the remission phases of this disease where you are trying to mitigate the consequences of severe muscle wastage -- or at least that is my personal experience.

The results of this XMRV study (with its endorsement by a number of the leading independent virologists) seem to me to be very important. However, validation studies and related impact studies plus some basic clinical/evaluation trials of retrovirus treatment options are surely going to take a minimum of 12 months, so even if this finding lives up to all it promises, and there is still a possibility that it might not, I would think that will be 18-24 months minimum before this starts to impact NIH / NHS recommendations for patient treatment and could therefore start to impact me personally. What concerns me is that in the interim we are going to get the usual bogus Internet offerings (such as you can already get an 'XMRV test' online), plus the uninformed advocacy / speculation. OK, perhaps I am guilty of this myself, but at least I have been coincidentally reading up on this area for over a year; I am working through one of the standard virology text books; and I do go back to the original pubmed refs. As I said above I don't think that this debate is a subject for wiki articles and article discussions just yet. TerryE (talk) 02:17, 18 November 2009 (UTC)

"Occam's razor" doesn't justify oversimplified exaggerated generalisations. While a range of stressors appear to be involved and should be recognised, at least half (more like the majority) have no significant onset psychological stressors, at least which explain the extent of the illness. Questionnaires used in such research should detect significant events reported by the participants even if no perceived as "stressful", so proposing "hidden stresses" is inadequate.

Of course, it's far easier to make sweeping claims than it is to demonstrate credible biological mechanisms, so there is going to be false dawns for biomedical models. It is interesting that RobinHood70 brought up peptic ulcers as an example of a changing medical paradigm when faced with new evidence, because earlier this year in 2009 after TerryE brought it up, Sciencewatcher was still claiming that "virtually everyone" has H.pylori, that it "doesn't cause ulcers", and that research finds stress to be the "most important factor" in said ulcers. These claims were never recanted, so I wouldn't expect Sciencewatcher to understand the significance of XMRV either even if it was actually confirmed to be a major factor (in most cases of Canadian-2003 defined ME/CFS) and effectively treated with pharmaceuticals.

Perhaps the most concerning aspect about Sciencewatcher's stance is that he seems to desire the suppression of biomedical research/proponents into CFS because they make him angry for the same reasons others are angry at psychosocial proponents (ie ignoring research, diverting funds, worsening stigma towards CFS, etc). I wonder if he harbours the same vitriol towards those researching the biological aspects/treatments of major depression and schizophrenia? It is often said that some CFS patients need to believe their illness is physical, but perhaps some others who recover need to believe that mental prowess cured their illness.

_Tekaphor (TALK) 12:06, 22 November 2009 (UTC)

Treatment for depression

Thanks for the work on Treatment for depression. I'm a bit surprised that you removed the tags given the state of the article. Could you explain, here or on the article talk page? --Ronz (talk) 22:35, 18 November 2009 (UTC)

I just thought I had fixed most of the issues. It looked like it was just a case of a whole bunch of crap sitting in the article for a year with people just tagging it and not bothering to fix it, so I fixed it and removed the tags. I'm sure there's more work to be done. If you think there is still a need for the tags, feel free to add them again. --sciencewatcher (talk) 22:40, 18 November 2009 (UTC)

Thanks! I think that we need to be very cautious of any sources that fail MEDRS, but for now I'll just tag for those that fail WP:RS. --Ronz (talk) 01:48, 19 November 2009 (UTC)