Chronic fatigue syndromes: real illnesses that people can recover from

The ‘Oslo Chronic Fatigue Consortium’ consists of researchers and clinicians who question the current narrative that chronic fatigue syndromes, including post-covid conditions, are incurable diseases. Instead, we propose an alternative view, based on research, which offers more hope to patients. Whilst we regard the symptoms of these conditions as real, we propose that they are more likely to reflect the brain's response to a range of biological, psychological, and social factors, rather than a specific disease process. Possible causes include persistent activation of the neurobiological stress response, accompanied by associated changes in immunological, hormonal, cognitive and behavioural domains. We further propose that the symptoms are more likely to persist if they are perceived as threatening, and all activities that are perceived to worsen them are avoided. We also question the idea that the best way to cope with the illness is by prolonged rest, social isolation, and sensory deprivation. Instead, we propose that recovery is often possible if patients are helped to adopt a less threatening understanding of their symptoms and are supported in a gradual return to normal activities. Finally, we call for a much more open and constructive dialogue about these conditions. This dialogue should include a wider range of views, including those of patients who have recovered from them

A population study of Norwegian psychiatric patients referred for clinical brain scanning

Background: Patients with psychiatric conditions are often referred for a brain scan during the course of their diagnostic workup. Aims: The aim of our study is to determine frequency and type of organic brain pathology, the relationship to age, gender and psychiatric diagnosis. Method: We investigated magnetic resonance imaging and computed tomography brain scans from consecutively referred patients over a 10-year period (January 2002-December 2011). The reasons for referral, estimated psychiatric diagnosis, and the pathology discovered for each patient were registered. Results: A total of 34% of patients demonstrated organic brain pathology, of which 32.8% were considered clinically relevant. This represents a higher frequency of relevant pathology than reported in healthy subjects. Age (P < 0.001) and diagnosis (P = 0.016) were the most important determinants for frequency of pathological findings. Conclusions: Brain imaging in clinical psychiatry resulted in approximately 30% positive findings mainly associated with increasing pathologies with age, but also with diagnosis. Declaration of interest: Both T.O.D. and M.K.B. have received honorary from Novartis for scientific lectures about multiple sclerosis. M.K.B. also received honoraria from Biogen for scientific lectures. The other authors have no conflicts of interest

A population study of Norwegian psychiatric patients referred for clinical brain scanning

Background Patients with psychiatric conditions are often referred for a brain scan during the course of their diagnostic workup. Aims The aim of our study is to determine frequency and type of organic brain pathology, the relationship to age, gender and psychiatric diagnosis. Method We investigated magnetic resonance imaging and computed tomography brain scans from consecutively referred patients over a 10-year period (January 2002-December 2011). The reasons for referral, estimated psychiatric diagnosis, and the pathology discovered for each patient were registered. Results A total of 34% of patients demonstrated organic brain pathology, of which 32.8% were considered clinically relevant. This represents a higher frequency of relevant pathology than reported in healthy subjects. Age (P < 0.001) and diagnosis (P = 0.016) were the most important determinants for frequency of pathological findings. Conclusions Brain imaging in clinical psychiatry resulted in approximately 30% positive findings mainly associated with increasing pathologies with age, but also with diagnosis. Declaration of interest Both T.O.D. and M.K.B. have received honorary from Novartis for scientific lectures about multiple sclerosis. M.K.B. also received honoraria from Biogen for scientific lectures. The other authors have no conflicts of interest