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Brian Walitt
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==Controversy== Walitt has stated his belief that [[fibromyalgia]] is a "psychosomatic experience," a variant of normal, and not an abnormal disease state that should be medicalized.<ref>[http://www.familypracticenews.com/specialty-focus/rheumatology/single-article-page/video-fibromyalgia-doesnt-fit-the-disease-model/e913134880916685f3005dac5459ab88.html VIDEO: Fibromyalgia doesnβt fit the disease model]</ref> He has stated that fibromyalgia is not a disease but rather a way of "dealing with the difficulties of just being a human.β<ref>[http://www.meaction.net/2016/02/20/nih-lead-clinical-investigator-thinks-cfs-is-psychosomatic/ NIH lead clinical investigator thinks CFS and fibro are somatoform], #MEAction, February 20, 2016</ref> In a 2015 paper on [[chemotherapy]] related [[cognitive dysfunction]]<ref>[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750385/ Chemobrain: A critical review and causal hypothesis of link between cytokines and epigenetic reprogramming associated with chemotherapy]</ref> co-authored by Walitt, [[fibromyalgia]] and [[chronic fatigue syndrome]] are referred to as [[somatoform]] illnesses, with their hallmark being a "...discordance between the severity of subjective experience and that of objective impairment...". Walitt has also stated that "Fibromyalgia is closely allied with and often indistinguishable from [[neurasthenia]]" and goes on to claim that "Time brings clarity to confusing illnesses of the past, and we now recognize that hysteria, neurasthenia, and railway spine were almost always psychogenic disorders."<ref>[http://www.nature.com/nrrheum/journal/v9/n12/abs/nrrheum.2013.96.html/ Culture, science and the changing nature of fibromyalgia]</ref> In a very small uncontrolled study (n = 9) exploring the relationship between [https://en.wikipedia.org/wiki/Gene_expression genetic expression] and [https://en.wikipedia.org/wiki/Pain_catastrophizing pain catastrophizing] in Fibromyalgia, Walitt and his co-authors used a score of 16 on the Pain Catastrophizing Scale as the threshold for determination of "high catastrophizing".<ref>[http://www.nursingoutlook.org/article/S0029-6554%2813%2900062-6/fulltext/ Gene expression profiles of fatigued fibromyalgia patients with different categories of pain and catastrophizing: A preliminary report]</ref> That is in stark contrast with the threshold of 30 recommended by the scale's creators to indicate a "clinically relevant level of catastrophizing," and a mean score for 851 injured workers was 20.90.<ref>[http://sullivan-painresearch.mcgill.ca/pdf/pcs/PCSManual_English.pdf The Pain Catastrophizing Scale: User Manual]</ref> Even the high catastrophizing subgroup (n = 5) in the study averaged a pain catastrophizing score of only 23.6, well below the recommended threshold. The authors concluded that "specific physiological pathways may possibly delineate pain and catastrophizing mechanisms."
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