Well said

You are correct about comorbidities and one of them is fibromyalgia which is still miss understood by most of the medical community including Mayo Clinic who tried to say that I had Munchhausen‘s! I finally went to other doctors that were local and they found diagnoses that Mayo Clinic never even thought of even though I gave him every medical record every symptom every surgery every allergy everything. I ended up canceling the rest of my appointments there because they Cut and wrap their head around the idea that fibromyalgia is real although they have a fibromyalgia clinic and want you to go through a three week pain management class the cost $42,000. People I’ve been dealing with fibromyalgia for 25 years I don’t need a $42,000 damn class or to be told that I have Munchhausen‘s. Since I quit seeing them I’ve been diagnosed with four different rare diseases including MALS.

I agree @sclindajanssen there is a concern that the study couples psychiatric problems with MALs diagnosis, doctors could be misinterpreting the study as further evidence that a lot of it is in the mind of the patient. At worst delay treatment in favour of psychiatric evaluation and therapy. As a whole the article does support the use of surgery to improve quality of life for a MALs sufferer. The psychiatric tendencies they referred to seem to be about substance and alcohol abuse rather than mental health issues. There are a few concerns which I address in a reply to @kariulrich