CDC mystery disease study heads toward finish line (Morgellons)

The Sunday Paper ^ | Sunday, August 03, 2008 | Spencer Freeman

[Marie]

My mom spent 20 years with undiagnosed Grave's disease. She finally had a thyroid storm that got everyone's attention. She was suicidal, screaming, high fever, just loosing her mind. The docs thought she was having a psychotic break and I went toe-to-toe with them. I've never been so belligerent in my life. I *insisted* that they admit her and start running tests. I threatened to sue the hospital. I don't even remember half the evil things I said.

Finally her family doc called and said, "admit her." They still didn't find out about the thyroid that week in the hospital. A few days after her release she went back to the doc for a follow-up and they checked her thyroid. Grave's.

I've also had my own fight for the last 20 years, but I won. Turns out I had Celiac disease which caused malnutrition. I had BeriBeri. After my first B1 shot, the heart problems went away. After two weeks of daily shots, the nerve damage reversed. (Permanent nerve damage, my *ss.) Took another month for my memory to improve.

Yeah, we're just crazy, depressed, trying to get attention... Sometimes I hate doctors.

[Rudder]

My assertion that this is a psychologic disorder has angered a few on this thread...I guess they want to be physically ill, and I won't argue with them.

There are many disorders similar to this and I've worked with a hundred or so. Of those who said they had specifically Morgellons, I've seen about 8-10 as referrals from other physicians. My Dx is usually (DSM) Axis I: 301.51 Factitious Disorder with Physical Symptoms. The best-studied form of this Dx is Munchhausen Syndrome. It is resistive to psychiatric intervention and no medication is indicated.

As the advertisement which sponsors this article says: Try NutriSilver...can't hurt.

[Shion]

>>My assertion that this is a psychologic disorder has angered a few on this thread.<<

You’re not totally alone.

My personal belief is that a combination of societal emphasis on continuous introspection, lack of general fitness, and ready availability of mounds of medical information on the internet has developed into a whole new level of hypochondria and mass hysteria.

Almost makes me wish I was less ethical. I’d make a mint selling my patented miracle tonics to the perpetually ailing.

[Rudder]

...ready availability of mounds of medical information on the internet has developed into a whole new level of hypochondria and mass hysteria.

This has become a common complaint voiced by physicians, who see a marked rise in hypochondriasis among their patients. Merely reading a list of signs and symptoms of a disease, without the requisite training, education and, most importantly---experience---can often lead lay people to falsely conclude they have a particular illness. A condition known as "medical student's disease" is frequently seen in students who have consumed prodigious amounts of medical literature but who do not yet have the full training and education.

In fact, one of the cautionary diagnostic signs of hypochondriasis, cited in the literature, is a patient who presents with a lengthy, detailed and elaborate medical history, along with a history of "doctor-shopping and a deterioration in "doctor-patient" relationships. Frustration and anger on both sides. are common.

[Shion]

Yes, now everyone with computer access can also suffer from 1st year med student disease.

Intrestingly I just saw a short article on “Münchhausen’s by Internet” where the ability to self-diagnose, combined with immediate gratification of attention and sympathy needs in many available on-line support groups (who don’t question whether one actually has the supported disorder) are powerful motivation to consider oneself ill.

Heck, I almost bought it. I was convinced I had hypothyroidism. Clearly had every symptom available. Turns out I was just lazy and eating too much, and diet and exercise fixed everything right up.

[Scythian]

Morgellons Disease

Robert C. Bransfield, M.D.

Red Bank, N.J.
Article

I am pleased to see that in the December 15, 2006, issue, Psychiatric News drew attention to Morgellons disease and that the excellent article gave sound advice on communicating with delusional parasitosis patients. However, I would like to add comments about the distinction between Morgellons disease and delusional parasitosis.

I've evaluated and treated Morgellons patients, spoken with researchers and other clinicians who work with these patients, read the limited literature on the subject, and reviewed a database of 3,000 Morgellons patients. The Morgellons patients I have seen had surprisingly similar symptoms, with an abrupt onset, often following a toxic exposure. Before the onset of their illness, these patients' mental status appeared to be quite representative of the general population, and some (including physicians) were high-functioning professionals. The condition appears more common in nurses, teachers, and in family members in the same household, which suggests a contagious component.

After the onset of the illness, these patients report surprisingly similar symptoms. They have a combination of bizarre dermatological sy mptoms, cognit ive impairments, mood disturbances, and sometimes paranoia and suicide attempts in later stages of the illness.

Their symptoms are not compatible with schizophrenia, bipolar illness, substance abuse, or other recognized causes of delusions. When patients complain of fibers protruding from their skin, examination with a low-power digital microscope can visualize and photograph the presence or absence of these fibers. In addition, many Morgellons patients test positive for Lyme disease. The mental symptoms seen in Morgellons are similar to those of other chronic general medical illnesses with psychiatric manifestations, since the mental symptoms fluctuate in a pattern similar to that of the general medical symptoms; and this suggests that the mental symptoms are probably associated with immune and/or toxic effects upon the brain.

When these patients are treated with modest courses of antibiotics, their dermatological and psychiatric symptoms often show significant improvement. Without a thorough assessment, Morgellons patients are commonly given a diagnosis of delusional parasitosis, resulting in a delay in proper treatment. Whatever Morgellons is, it is something very different and unique and should be considered as a condition needing further study and possibly listed in the next edition of the DSM.

In summary, Morgellons disease and delusional parasitosis are two distinct clinical entities. Morgellons does not appear to be an imaginary or delusional illness and merits the research effort that we see with any other emerging and serious illness.

[Ole Okie]

Merely reading a list of signs and symptoms of a disease, without the requisite training, education and, most importantly---experience---can often lead lay people to falsely conclude they have a particular illness.

As my very wise mother used to say, when she read the symptoms of an illness, she had all those symptoms.

Except loss of appetite.