Brian Walitt, M.D., M.P.H. is a researcher in the Division of Intramural Research within the National Center for Complimentary and Integrative Health at the National Institutes of Health (NIH) in the United States and oversees intramural clinical protocols. He is the lead clinical investigator of the NIH Post-Infectious ME/CFS Study.
Research[edit | edit source]
He is interested in studying "perceptual illness" which he defines as follows:
"In these disorders, a person experiences a range of different bodily sensations, such as pain and fatigue, without any clear external cause. In some, these sensations can be bothersome while in others they can be disabling. The perceptual illnesses that interest me change their names with every generation, with current disorders being called fibromyalgia, chronic fatigue syndrome, and post-Lyme syndrome." 
Controversy[edit | edit source]
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. He has stated that fibromyalgia is not a disease but rather a way of "dealing with the difficulties of just being a human.”
In a 2015 paper on chemotherapy related cognitive dysfunction 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."
In a very small uncontrolled study (n = 9) exploring the relationship between genetic expression and 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". 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. 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."
Notable studies[edit | edit source]
- 2007, The effects of multidisciplinary therapy on positron emission tomography of the brain in fibromyalgia: a pilot study
- 2012, The Changing Nature of Fibromyalgia
- 2013, Increased Brain White Matter Axial Diffusivity Associated with Fatigue, Pain and Hyperalgesia in Gulf War Illness (Full Text)
- 2015, Chemobrain: A critical review and causal hypothesis of link between cytokines and epigenetic reprogramming associated with chemotherapy
- 2015, Neuroimaging of Central Sensitivity Syndromes: Key Insights from the Scientific Literature
Talks and interviews[edit | edit source]
Online presence[edit | edit source]
See also[edit | edit source]
Learn more[edit | edit source]
- 2009, Fibromyalgia 201
- 2012, The Changing Nature of Fibromyalgia Frederick Wolfe and Brian Walitt
- 2013, Demystifying Medicine 2013 - Pain: How It Happens and What Can Be Done?
- 2015, Prevalence of Fibromyalgia in Elderly Women
- 2016, The Psychosomatic Researcher in the NIH's Big Chronic Fatigue Syndrome (ME/CFS) Study
- 2016, NIH's initial response to comments and article on Walitt
- 2016, Brian Walitt’s Radical Bias: Disorders of Subjective Perception, ME/CFS as Normal Life Experience?
References[edit | edit source]
- Georgetown-Howard Universities Center for Clinical and Translational Science
- VIDEO: Fibromyalgia doesn’t fit the disease model
- NIH lead clinical investigator thinks CFS and fibro are somatoform, #MEAction, February 20, 2016
- Chemobrain: A critical review and causal hypothesis of link between cytokines and epigenetic reprogramming associated with chemotherapy
- Culture, science and the changing nature of fibromyalgia
- Gene expression profiles of fatigued fibromyalgia patients with different categories of pain and catastrophizing: A preliminary report
- The Pain Catastrophizing Scale: User Manual
- Rayhan RU, Stevens BW, Timbol CR, Adewuyi O, Walitt B, VanMeter JW, Baraniuk JN. (2013) Increased Brain White Matter Axial Diffusivity Associated with Fatigue, Pain and Hyperalgesia in Gulf War Illness. PLoS ONE 8(3): e58493. https://doi.org/10.1371/journal.pone.0058493
- NIH lead clinical investigator thinks CFS and fibro are somatoform
National Institutes of Health (NIH) - A set of biomedical research institutes operated by the U.S. government, under the auspices of the Department of Health and Human Services.
chronic fatigue syndrome (CFS) - A controversial term, invented by the U.S. Centers for Disease Control, that generally refers to a collection of symptoms as “fatigue”. There have been multiple attempts to come up with a set of diagnostic criteria to define this term, but few of those diagnostic criteria are currently in use. Previous attempts to define this term include the Fukuda criteria and the Oxford criteria. Some view the term as a useful diagnostic category for people with long-term fatigue of unexplained origin. Others view the term as a derogatory term borne out of animus towards patients. Some view the term as a synonym of myalgic encephalomyelitis, while others view myalgic encephalomyelitis as a distinct disease.
somatic symptom disorder - A psychiatric term to describe an alleged condition whereby a person's thoughts somehow cause physical symptoms. The actual existence of such a condition is highly controversial, due to a lack of scientific evidence. It is related to other psychiatric terms, such as "psychosomatic", "neurasthenia", and "hysteria". Older terms include "somatization", "somatoform disorder", and "conversion disorder". Such terms refer to a scientifically-unsupported theory that claims that a wide range of physical symptoms can be created by the human mind, a theory which has been criticized as "mind over matter" parapsychology, a pseudoscience. Although "Somatic Symptom Disorder" is the term used by DSM-5, the term "Bodily Distress Disorder" has been proposed for ICD-11. (Learn more: www.psychologytoday.com)