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Comment by Klinky | Hacker News Reader

Sample size of 35 and mindfulness is not novel or new. It probably does help some people. However, a huge grain of salt should be taken with any diagnosis illness/disease being due to stress or psychosomatic. Some doctors immediately jump to this after doing very little due diligence and diagnostics. It should be a diagnosis of absolute last resort.

Stanford does have a CFS clinic investigating pathogen-related causes[1].

1. https://med.stanford.edu/chronicfatiguesyndrome.html

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This is not mindfulness. They actually compared against a mindfulness-based treatment (MBSR) and found their method performed significantly better.

They literally have you go through "Worry Less, Live More: The Mindful Way Through Anxiety Workbook", so it's at least building off of it in some way. Mindfulness with a pain-oriented focus is not new.

Looking at their patient groups on Table 1, it seems MBSR and Usual Care had participants with more spinal injections and surgical interventions. MBSR and Usual Care have higher "Pain bothersomeness" scores and "Roland Disability Questionnaire Scores" at the start.

It's a very small-scale pilot study. I am very skeptical it's not a ploy to try to sell his books.

Agreed, sample arms were n=11 or 12.

MBSR teacher (well, learning!) here. I would also be skeptical based purely on the sample size, but MBSR as a treatment is pretty well researched and documented. It's been around for 40+ years and there is fairly extensive supporting research [1].

So - I wouldn't be in any way surprised if there are other related treatments which have high levels of efficacy...

[1] https://en.wikipedia.org/wiki/Mindfulness-based_stress_reduc...

>It should be a diagnosis of absolute last resort.

No, it should be equal.

>Stanford does have a CFS clinic investigating pathogen-related causes[1].

They haven't come up with anything, and their scientists are problematic: Montoya getting fired for sexual harassment, and Davis saying that anyone who doesn't think CFS has a molecular basis is a fool.

>No, it should be equal.

Okay, what is the consistent testing/diagnostic methodology that accurately measures stress and psychosomatic impact across patients?

Typically it is going to be a diagnosis of exclusion. If you think you're diagnosing someone with stress/psychosomatic causes before comprehensive testing, imaging and/or specialists visit have been done, then you're jumping the gun, and potentially adding further stress to the patient as they try to follow a regimen that has little effect at helping their condition.

I was not aware of the Stanford CFS clinic drama.

Yes, the doctor should explore all possible causes with the patient. Tests can be done, and the doctor can also discuss stress. That is generally how it is done. Quite often in these cases there will be no final diagnosis.

That sounds a lot like a diagnosis of last resort. Especially if the best tool available for measuring stress is a yes/no question to the patient and a 5-question anxiety questionnaire. Hardly definitive evidence of stress/psychosomatic causes, especially if it comes back "negative".

There is no “stress” diagnosis test. It can never be a definitive diagnosis. The patient just needs to consider it.

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