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Medically unexplained physical symptoms
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== Forced treatment == The classification of physically ill patients as having a mental illness purely on the basis of their psychical symptoms allows for a patient to be '''forcibly treated''' if they are judged to be lacking ''mental capacity'', something which can occur in severe ME due to be severe [[Cognitive dysfunction|cognitive]] and concentration problems, or episodes or [[Speech difficulties|speech loss]] and [[paralysis]] that prevent communication.<ref>{{Cite web|url=http://www.sophiaandme.org.uk/ | title = Sophia and M.E. | website = sophiaandme.org.uk|access-date=2019-07-15}}</ref> Despite ME patients not experiencing psychosis or other psychiatric conditions that effect judgement as part of ME, the "mentally ill" label can be, and has been, used to assume patients lack capability for treatment decisions, and to force them into harmful treatments including [[exercise]] or [[Graded exercise therapy|exercise therapies]].<ref name="Spandler2017" /> Historically, illnesses that were previously misunderstood or not yet identified were blamed on patients' [[Personality traits and patient attitudes in ME/CFS|personality]], for example William Henry Day's concept of the "migraine personality" in 1878, Diamond and Dalessio (1973) claims that "up to 90% [of those with migraines] have a psychogenic basis for their complaint", patients were labeled as "untrustworthy", "drug-seeking", or as potential malingerers.<ref name="Segal2007">{{Cite journal | last = Segal|first = Judy Z. | authorlink = | date = 2007-04-01 | title = Illness as argumentation: a prolegomenon to the rhetorical study of contestable complaints|url=https://doi.org/10.1177/1363459307074695|journal=Health|language=en|volume=11|issue=2|pages=227–244|doi=10.1177/1363459307074695|issn=1363-4593|quote=|via=}}</ref><ref name="Spotalia2013">{{Cite web|url=http://occupyme.net/2013/12/19/my-feedback-to-the-institute-of-medicine/ | title = My feedback to the Institute of Medicine | last= Jennie | first = Spotila | authorlink=Jennie Spotila | date = 2013 | website = occupyme.net|archive-url=|archive-date=|url-status=|access-date=2019-07-10}}</ref> [[Systemic lupus erythematosus|Lupus]], [[multiple sclerosis]], and [[Lyme disease]] are all examples of illnesses that were previously assumed to have a psychological origin simply because of the "absence of evidence" of a physical cause.<ref name="English2000" /><ref name="Williams2014" /> English (2000) states that "Absence of evidence may reflect insufficient research, inadequate technology, poor methods, flawed paradigms, closed minds, or lack of clinical experience; for example, in 1980, there was no clear evidence that AIDS was viral—blood products were considered “safe.”"<ref name="English2000">{{Cite journal | last = English|first = T.L. | authorlink = | date = Feb 15, 2000 | title = Functional somatic syndromes|url=https://www.researchgate.net/profile/Ellen_Goudsmit/publication/12634788_Functional_somatic_syndromes/links/00b49532e9e9d67056000000/Functional-somatic-syndromes.pdf?origin=publication_detail|journal=Annals of Internal Medicine|volume=132|issue=4 | pages = 329|issn=0003-4819|pmid=10681297|via=}}</ref>
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