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Diamond PR, Dysch L, Daniels J. Health anxiety in stroke survivors: a cross-sectional study on the prevalence of health anxiety in stroke survivors and its impact on quality of life. Disabil Rehabil 2023; 45:27-33. [PMID: 34990561 DOI: 10.1080/09638288.2021.2022778] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE To explore the prevalence of health anxiety in stroke survivors and its relative impact on quality of life. MATERIALS AND METHODS A cross-sectional design was used including between group comparisons of high and low health anxious stroke survivors. Stroke survivors (n = 105) were recruited via online stroke community forums. Participants completed measures of health anxiety (Short Health Anxiety Inventory), general anxiety and depression (Hospital and Anxiety and Depression Scale), disability (WHO Disability Assessment Schedule), and quality of life (Quality of Life Index). Demographics and medical histories were also assessed. RESULTS Thirty percent of the sample scored above the clinical cut off for health anxiety. Stroke survivors with high health anxiety (HiHA) were found to have significantly lower quality of life (p < 0.001) and higher rates of depression (p < 0.001). Regression analysis found health anxiety to be a significant predictor of quality of life (β = -0.12; p < 0.05) in addition to levels of depression (β = -0.33; p < 0.001) and disability (β = -0.53; p < 0.001). CONCLUSIONS Almost a third of stroke survivors were experiencing clinical levels of health anxiety, with HiHA significantly associated with lower quality of life. Future research should explore the use of existing evidence based psychological interventions for health anxiety in this population.Implications for rehabilitationOur findings suggest almost one in three stroke survivors residing in the community have clinical levels of health anxiety.High health anxiety in stroke survivors was significantly related to lower levels of quality of life.Given this finding, evidence-based treatments for health anxiety may improve quality of life and reduce distress for a significant proportion of stroke survivors.Rehabilitation approaches aimed at improving overall quality of life for stroke survivors should consider both physical and psychological interventions, with levels of physical disability, depression and anxiety all significantly associated with quality of life.
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Affiliation(s)
| | - Leon Dysch
- Community Neuro and Stroke Service, St Martins Hospital, Bath, UK
| | - Jo Daniels
- Department of Psychology, University of Bath, Bath, UK
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2
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Filser M, Buchner A, Fink GR, Gold SM, Penner IK. The manifestation of affective symptoms in multiple sclerosis and discussion of the currently available diagnostic assessment tools. J Neurol 2023; 270:171-207. [PMID: 36129540 PMCID: PMC9813146 DOI: 10.1007/s00415-022-11359-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION In addition to physical and cognitive symptoms, patients with multiple sclerosis (MS) have an increased risk of experiencing mental health problems. METHODS This narrative review provides an overview of the appearance and epidemiology of affective symptoms in MS such as depression, anxiety, bipolar disorder, euphoria, and pseudobulbar affect. Furthermore, the association between affective symptoms and quality of life and the currently used diagnostic instruments for assessing these symptoms are considered whereby relevant studies published between 2009 and 2021 were included in the review. RESULTS Patients with mild and moderate disability more frequently reported severe problems with depression and anxiety than severe mobility problems. Apart from the occurrence of depression, little is known about the association of other affective symptoms such as anxiety, bipolar disorder, euphoria, and pseudobulbar affect and subsyndromal symptoms, which fail to meet the diagnostic criteria but are nevertheless a significant source of distress. Although there are a few recommendations in the research to perform routine screenings for diagnosable affective disorders, a standardized diagnostic procedure to assess subsyndromal symptoms is still lacking. As the applied measurements are diverse and show low accuracy to detect these symptoms, patients who experience affective symptoms are less likely to be identified. DISCUSSION In addition to the consideration of definite psychiatric diagnoses, there is an unmet need for a common definition and assessment of disease-related affective symptoms in MS. Future studies should focus on the improvement and standardization of a common diagnostic procedure for subsyndromal affective symptoms in MS to enable integrated and optimal care for patients.
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Affiliation(s)
- Melanie Filser
- Department of Experimental Psychology, Heinrich Heine University, Düsseldorf, Germany.,COGITO Centre for Applied Neurocognition and Neuropsychological Research, Life Science Centre, Düsseldorf, Germany
| | - Axel Buchner
- Department of Experimental Psychology, Heinrich Heine University, Düsseldorf, Germany
| | - Gereon Rudolf Fink
- Department of Neurology, University of Cologne, Cologne, Germany.,Institute of Neuroscience and Medicine (INM-3), Research Centre, Cognitive Neuroscience, Jülich, Germany
| | - Stefan M Gold
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin (CBF), Charité Universitätsmedizin Berlin, Berlin, Germany.,Medical Department, Section Psychosomatics, Charité Universitätsmedizin Berlin, Berlin, Germany.,Institute of Neuroimmunology and Multiple Sclerosis (INIMS), Center for Molecular Neurobiology, University Medical Center, Hamburg-Eppendorf, Germany
| | - Iris-Katharina Penner
- Department of Neurology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. .,COGITO Centre for Applied Neurocognition and Neuropsychological Research, Life Science Centre, Düsseldorf, Germany. .,Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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3
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Österman S, Axelsson E, Lindefors N, Hedman-Lagerlöf E, Hedman-Lagerlöf M, Kern D, Svanborg C, Ivanov VZ. The 14-item short health anxiety inventory (SHAI-14) used as a screening tool: appropriate interpretation and diagnostic accuracy of the Swedish version. BMC Psychiatry 2022; 22:701. [PMID: 36376898 PMCID: PMC9664720 DOI: 10.1186/s12888-022-04367-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The 14-item Short Health Anxiety Inventory (SHAI-14) is a common measure of health anxiety but its screening properties have not been studied. The aims of this study were to evaluate the SHAI-14 as a screening instrument, identify cut-offs for clinically significant health anxiety and investigate which scores correspond to different severity levels. METHOD The study included 1729 psychiatric patients and 85 healthy controls. Participants completed the SHAI-14 and underwent a diagnostic interview. Cut-off scores were evaluated in three scenarios to approximate screening 1) in a psychiatric clinic, 2) in a low prevalence setting and, 3) of healthy volunteers (cut-off for remission). Receiver operating characteristics were used. Classification of severity was based on the distribution of SHAI-14 scores reported by patients with clinically significant health anxiety. RESULTS The area under the curve (AUC) values were high in all scenarios (above 0.95). The optimal cut-off scores on the SHAI-14 were 22 in the psychiatric context, 29 in a setting with low prevalence of psychiatric disorders and 18 versus healthy controls. SHAI-14 scores of 0-27 represented no or mild health anxiety, 28-32 moderate health anxiety and 33-42 substantial health anxiety. CONCLUSION Brief self-report measures used as screening instruments are a simple way of gathering information about the presence of specific symptoms and thus a way to detect the likelihood of a diagnosis. The SHAI-14 shows evidence of good diagnostic utility in both clinical and non-clinical settings. However, which cut-off score is to be used, depends on the intended purpose and the setting where the cut-off is used.
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Affiliation(s)
- Susanna Österman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18A, SE-171 77, Stockholm, Sweden.
| | - Erland Axelsson
- grid.4714.60000 0004 1937 0626Division of psychology, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 6, SE-17165 Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels allé 23, SE-141 83 Huddinge, Sweden ,Liljeholmen Primary Health Care Clinic, Region Stockholm, Liljeholmstorget 7, SE-117 94 Stockholm, Sweden
| | - Nils Lindefors
- grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18A, SE-171 77 Stockholm, Sweden
| | - Erik Hedman-Lagerlöf
- grid.4714.60000 0004 1937 0626Division of psychology, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 6, SE-17165 Stockholm, Sweden ,Gustavsberg Primary Health Care Clinic, Region Stockholm, Odelbergs väg 19, SE-134 40 Gustavsberg, Sweden
| | - Maria Hedman-Lagerlöf
- grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden
| | - Dorian Kern
- grid.4714.60000 0004 1937 0626Division of psychology, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 6, SE-17165 Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden
| | - Cecilia Svanborg
- grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18A, SE-171 77 Stockholm, Sweden
| | - Volen Z. Ivanov
- grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18A, SE-171 77 Stockholm, Sweden
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4
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Hoepner R, Rodgers S, Stegmayer K, Steinemann N, Haag C, Calabrese P, Manjaly ZM, Salmen A, Kesselring J, Zecca C, Gobbi C, Puhan MA, Walther S, von Wyl V. Feelings of loneliness, COVID-19-specific-health anxiety and depressive symptoms during the first COVID-19 wave in Swiss persons with multiple sclerosis. Sci Rep 2022; 12:17829. [PMID: 36280696 PMCID: PMC9591317 DOI: 10.1038/s41598-022-22445-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/14/2022] [Indexed: 01/20/2023] Open
Abstract
The aim of our study was to investigate whether self-reported feeling of loneliness (FoL) and COVID-19-specific health anxiety were associated with the presence of depressive symptoms during the first coronavirus disease 2019 (COVID-19) wave. Questionnaires of 603 persons of the Swiss Multiple Sclerosis Registry (SMSR) were cross-sectionally analyzed using descriptive and multivariable regression methods. The survey response rate was 63.9%. Depressive symptoms were assessed by the Beck Depression Inventory-Fast Screen (BDI-FS). COVID-19-specific health anxiety and FoL were measured using two 5-item Likert scaled pertinent questions. High scoring FoL (2.52, 95% confidence interval (CI) (2.06-2.98)) and/or COVID-19 specific health anxiety (1.36, 95% CI (0.87-1.85)) were significantly associated with depressive symptoms. Further stratification analysis showed that the impact of FoL on depressive symptoms affected all age groups. However, it was more pronounced in younger PwMS, whereas an impact of COVID-19 specific health anxiety on depressive symptoms was particularly observed in middle-aged PwMS. FoL and COVID-19-specific health anxiety were age-dependently associated with depressive symptoms during the first COVID-19 wave in Switzerland. Our findings could guide physicians, health authorities, and self-help groups to better accompany PwMS in times of public health crises.
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Affiliation(s)
- Robert Hoepner
- grid.411656.10000 0004 0479 0855Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Stephanie Rodgers
- grid.7400.30000 0004 1937 0650Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zürich, Switzerland
| | - Katharina Stegmayer
- grid.5734.50000 0001 0726 5157Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Nina Steinemann
- grid.7400.30000 0004 1937 0650Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zürich, Switzerland
| | - Christina Haag
- grid.7400.30000 0004 1937 0650Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zürich, Switzerland
| | - Pasquale Calabrese
- grid.6612.30000 0004 1937 0642Division of Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland
| | - Zina-Mary Manjaly
- grid.415372.60000 0004 0514 8127Department of Neurology, Schulthess Clinic, Zürich, Switzerland ,grid.5801.c0000 0001 2156 2780Department of Health Sciences and Technology, Eidgenössische Technische Hochschule (ETH) Zurich, Zürich, Switzerland
| | - Anke Salmen
- grid.411656.10000 0004 0479 0855Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Jürg Kesselring
- grid.483468.50000 0004 0563 7692Department of Neurology and Neurorehabilitation, Rehabilitation Centre Kliniken Valens, Valens, Switzerland
| | - Chiara Zecca
- grid.469433.f0000 0004 0514 7845Multiple Sclerosis Center, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland ,grid.29078.340000 0001 2203 2861Faculty of Biomedical Sciences, Università Della Svizzera Italiana (USI), Lugano, Switzerland
| | - Claudio Gobbi
- grid.469433.f0000 0004 0514 7845Multiple Sclerosis Center, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland ,grid.29078.340000 0001 2203 2861Faculty of Biomedical Sciences, Università Della Svizzera Italiana (USI), Lugano, Switzerland
| | - Milo A. Puhan
- grid.7400.30000 0004 1937 0650Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zürich, Switzerland
| | - Sebastian Walther
- grid.5734.50000 0001 0726 5157Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Viktor von Wyl
- grid.7400.30000 0004 1937 0650Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zürich, Switzerland ,grid.7400.30000 0004 1937 0650Institute for Implementation Science in Health Care, University of Zurich (UZH), Zurich, Switzerland
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Bahmani B, Mehraban S, Carnero Contentti E, Azkhosh M, Khanjani M, Azimian M. Relationship of coping strategies with mood symptoms, disease related characteristics and demographic variables in patients with multiple sclerosis: A systematic review study. Mult Scler Relat Disord 2022; 67:104163. [PMID: 36126537 DOI: 10.1016/j.msard.2022.104163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 08/13/2022] [Accepted: 09/05/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE the aim of this systematic review was to summarize the coping strategies utilized by people with multiple sclerosis (pwMS) and the association of these strategies with mood symptoms, quality of life, fatigue and disability in pwMS. METHODS search in the literature was performed across electronic databases of PubMed, Web of Science, and Scopus. No time constraint was applied for searching across the databases. Manual search was also performed on the list of references of the retrieved papers. Two authors independently evaluated the retrieved citations based on predetermined inclusion criteria in two screening stages. This systematic review followed Joanna Briggs Institute (JBI) guidelines for cross-sectional research. The findings related to the coping patterns against MS as well as the relationship between the patterns and MS symptoms were extracted and synthesized. FINDINGS A total of 2390 records were identified. After removing duplicates and based on screening, 39 papers met the eligibility criteria for qualitative synthesis, and they were evaluated in terms of quality of study. When comparing genders, women used more religious coping, social support seeking, and positive coping compared to men. Depression and anxiety were associated with maladaptive and emotion-oriented coping strategies. The patients who used positive and problem solving oriented coping strategies had a better score of quality of life. Disability and fatigue were associated with applying avoidance and maladaptive coping strategies. CONCLUSION the findings of this review suggest that understanding the relationship between coping strategies and quality of life as well as the symptoms related to the disease is important to understand development of psychological interventions adopted by specialists to support these patients.
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Affiliation(s)
- Bahman Bahmani
- Department of counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Shafigh Mehraban
- Department of counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | | | - Manouchehr Azkhosh
- Department of counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammadsaeed Khanjani
- Department of counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mojtaba Azimian
- Department of Clinical Science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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6
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Hosseinchi P, Ghalibaf E, Dehghani A, Khatibi A. Negative Interpretation of Ambiguous Bodily Information by Patients With Relapsing-Remitting Multiple Sclerosis. Mult Scler Relat Disord 2022; 62:103808. [DOI: 10.1016/j.msard.2022.103808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/29/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
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7
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Kurcer MA, Erdogan Z, Cakir Kardes V. The effect of the COVID-19 pandemic on health anxiety and cyberchondria levels of university students. Perspect Psychiatr Care 2022; 58:132-140. [PMID: 34018194 PMCID: PMC8242608 DOI: 10.1111/ppc.12850] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 04/11/2021] [Accepted: 05/02/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Our study hypothesizes that the fear and panic of COVID-19 triggers cyberchondria (CYB) in students thus increasing health anxiety. In this way, we aim to determine the effect of the belief of previously having had and not having had COVID-19 on health anxiety and CYB levels of the university students. METHODS Our study is a descriptive cross-sectional study. The target population of our study consisted of 950 students who were continuing their education in the Vocational School of Health Services, an associate degree program of a university, and the samples consisted of 794 students (85.5%) who filled out our questionnaire (n = 794). The questionnaire form included the information regarding sociodemographic characteristics and the symptoms of COVID-19, and the obtained data were electronically collected altogether with Cyberchondria Scale (CS) and Health Anxiety Inventory. FINDINGS Health anxiety mean scores were significantly higher in people who lived alone, had a chronic disease, searched for symptoms online, and took herbal supplements against COVID-19 (p < 0.05). The mean total scores of Health Anxiety Inventory, CS, Anxiety-Increasing Factors Subscale of the students who believe they have had COVID-19 were significantly lower compared to the scores of those who believe they have not had COVID-19. Nevertheless, women and people living alone and in cities had significantly high CS scores (p < 0.05). CONCLUSION The increase in infodemia can be prevented with the services offered by specialists through mental health helpline or websites to people with high health anxiety or CYB levels, especially to women, and to people living alone and in urban areas.
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Affiliation(s)
- Mehmet A. Kurcer
- Department of Public Health, Faculty of MedicineBulent Ecevit UniversityZonguldakTurkey
| | - Zeynep Erdogan
- Nursing Department, Ahmet Erdoğan Vocatıonal School of Health ServicesBulent Ecevit UniversityZonguldakTurkey
| | - Vildan Cakir Kardes
- Department of Psychiatry, Faculty of MedicineBulent Ecevit UniversityZonguldakTurkey
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Traino KA, Hawkins MA, Chaney JM, Mullins LL. The role of health anxiety in healthcare management transition and health-related quality of life in young adults with medical conditions. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.1983434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Katherine A. Traino
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, Stillwater, OK, USA
| | - Misty A.W. Hawkins
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, Stillwater, OK, USA
| | - John M. Chaney
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, Stillwater, OK, USA
| | - Larry L. Mullins
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, Stillwater, OK, USA
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9
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ShahAli S, Choobsaz H, Ebrahimi R. COVID-19 related knowledge, anxiety, depression and physical activity among Iranian people with relapsing-remitting multiple sclerosis during COVID-19 pandemic: an online cross-sectional survey. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2021. [DOI: 10.1080/21679169.2021.1958055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Shabnam ShahAli
- Department of Physiotherapy, School of Rehabilitation Sciences, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Haniyeh Choobsaz
- Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhane Ebrahimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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10
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Dattilo TM, Roberts CM, Fisher RS, Traino KA, Edwards CS, Pepper-Davis M, Chaney JM, Mullins LL. The Role of Avoidance Coping and Illness Uncertainty in the Relationship Between Transition Readiness and Health Anxiety. J Pediatr Nurs 2021; 59:125-130. [PMID: 33878537 DOI: 10.1016/j.pedn.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE The transition to college is associated with numerous stressors, including environmental changes, increased academic expectations, and changes in social support, all of which may be exacerbated by the added responsibility of managing a chronic medical condition. Huang (2019) proposed a model examining the relationships between coping styles, transition readiness, and health anxiety, and suggested that greater transition readiness is associated with adaptive coping strategies and less health anxiety. However, there are limited findings as to how poor transition readiness relates to health anxiety. Therefore, the current study tested a serial mediation model (i.e., poor transition readiness → avoidance coping → illness uncertainty → health anxiety). DESIGN AND METHODS College students (N = 194) with a chronic medical condition completed self-report questionnaires. RESULTS Results indicated several direct effects among the modeled variables and a significant poor transition readiness → avoidance coping → illness uncertainty → health anxiety serial mediation (path a1d21b2 = 0.438, 95% CI = 0.153 to 0.913). CONCLUSIONS Worse transition readiness was associated with increased avoidance as a coping mechanism, which in turn is associated with increased illness uncertainty, and ultimately health anxiety. The current findings identified possible drivers of health anxiety in college students with a chronic medical condition. PRACTICE IMPLICATIONS These findings highlight that good transition readiness skills may buffer against maladaptive avoidance, illness uncertainty, and health anxiety. Modules aimed at improving healthcare management, avoidance, and illness uncertainty may be beneficial additions to interventions to reduce health anxiety.
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Affiliation(s)
- Taylor M Dattilo
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, OK, USA.
| | - Caroline M Roberts
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Rachel S Fisher
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Katherine A Traino
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Clayton S Edwards
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Morgan Pepper-Davis
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - John M Chaney
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Larry L Mullins
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, OK, USA
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11
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Raimo S, Santangelo G, Trojano L. The emotional disorders associated with multiple sclerosis. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:197-220. [PMID: 34389118 DOI: 10.1016/b978-0-12-822290-4.00009-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Multiple sclerosis (MS) is associated with a high prevalence of emotional and mood disorders. Emotional disorders may worsen during illness progression and affect the quality of life of patients and their families. MS is often associated with depression, with an increased risk of suicide, poor adherence to treatment, decreased functional status, and quality of life. The diagnosis and treatment of emotional and mood disorders in these patients is often challenging since several symptoms of these disorders overlap with those of MS. Other prevalent emotional disorders in MS include bipolar disorder, anxiety disorders, emotional blunting (apathy), and pseudobulbar affect. Early recognition and treatment of these comorbidities could contribute to the reduction of disability and even to decreased mortality. The aim of this chapter is to provide an up-to-date review of mood and emotional disorders that are often associated with MS, focusing on their epidemiology, clinical features, pathogenesis, assessment, and treatment. The interplay between the psychosocial impact of the chronic disability and the demyelinating structural lesions of the brain in precipitating emotional and mood disorders is discussed, as well as its implications for diagnosis and treatment.
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Affiliation(s)
- Simona Raimo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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12
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Lebel S, Mutsaers B, Tomei C, Leclair CS, Jones G, Petricone-Westwood D, Rutkowski N, Ta V, Trudel G, Laflamme SZ, Lavigne AA, Dinkel A. Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates. PLoS One 2020; 15:e0234124. [PMID: 32716932 PMCID: PMC7384626 DOI: 10.1371/journal.pone.0234124] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with chronic diseases commonly report fears of illness or symptoms recurring or worsening. These fears have been addressed from an illness-specific perspective (e.g., fear of cancer recurrence), a generic illness perspective (e.g., fear of progression), and a psychiatric perspective (DSM-5 illness anxiety disorder and somatic symptom disorder). The broader concept of health anxiety (HA) can also be applied to patients with a chronic disease. This review was conducted to investigate the conceptual, theoretical, measurement-overlap, and differences between these distinct perspectives. We also aimed to summarize prevalence, course, and correlates of these fears in different chronic illnesses. METHODS We used PsycINFO, PubMED, CINAHL, Web of Science, SCOPUS, and PSYNDEX to conduct a systematic review of studies pertaining to these fears in chronic illness published from January 1996 to October 2017. A total of 401 articles were retained. RESULTS There were commonalities across different conceptualizations and diseases: a high prevalence of clinical levels of fears (>20%), a stable course over time, and a deleterious impact on quality of life. Reviewed studies used definitions, models, and measures that were illness-specific, with only a minority employing a psychiatric perspective, limiting cross-disease generalizability. There appears to be some applicability of DSM-5 disorders to the experience of fear of illness/symptoms in patients with a chronic illness. While conceptualizing HA on a continuum ranging from mild and transient to severe may be appropriate, there is a lack of agreement about when the level of fear becomes 'excessive.' The definitions, models, and measures of HA across chronic illnesses involve affective, cognitive, behavioral, and perceptual features. CONCLUSIONS The concept of HA may offer a unifying conceptual perspective on the fears of illness/symptoms worsening or returning commonly experienced by those with chronic disease.
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Affiliation(s)
- Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Christina Tomei
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Georden Jones
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Nicole Rutkowski
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Viviane Ta
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Geneviève Trudel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Cheng ST. The Effect of Negative Aging Self-Stereotypes on Satisfaction With Social Support. J Gerontol B Psychol Sci Soc Sci 2020; 75:981-990. [PMID: 30289489 DOI: 10.1093/geronb/gby113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Previous studies have demonstrated a relationship between negative age self-stereotypes and social support satisfaction. This study examined whether negative age stereotype plays a causal role, and whether health anxiety is a possible mediator, in this relationship. METHODS A total of 114 Chinese older persons were randomly assigned into three experimental conditions. In two of the conditions, participants were primed with either negative or positive age stereotypes using a sentence unscrambling task, before responding to measures of self-perception of aging, health anxiety, and satisfaction with family and nonfamily support. Those in the control condition responded to the same questions without priming. RESULTS Main effects of priming were found across the board except for satisfaction with nonfamily support. In general, participants primed with negative age stereotypes reported more negative self-perception of aging, higher health anxiety, and lower satisfaction with family support, compared with control or those primed with positive age stereotypes. However, the effect on family support satisfaction could not be explained by concomitant experimental effect on health anxiety. DISCUSSION The central role of the family as a support provider might be the reason why the activation of negative age stereotypes led to less satisfaction with family, but not nonfamily.
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Affiliation(s)
- Sheung-Tak Cheng
- Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, Hong Kong.,Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norfolk, UK
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Prabha L, Ganjekar S, Gupta V, Desai G, Chaturvedi SK. A Comparative Study of Health Anxiety in Neurology and Psychiatry Settings. J Neurosci Rural Pract 2020; 11:125-129. [PMID: 32140015 PMCID: PMC7055604 DOI: 10.1055/s-0039-3399395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives
Prevalence of health anxiety is highly varied based on different settings and samples studied. This study aimed to assess the prevalence of health anxiety among outpatients attending neurology and psychiatry outpatient setting in tertiary care hospital and understand the clinical correlates.
Participants and Methods
This was a cross-sectional study conducted in the outpatient settings including participants fulfilling study criteria. The assessments included semi-structured proforma for demographic and clinical details, general hypochondriasis subscale of Illness Behavior Questionnaire, and Short Health Anxiety Inventory. Data were collected in Epi-info and data analysis was done using STATA12.
Results
The health anxiety was reported to be 25% and 19% among psychiatry and neurology outpatients, respectively. Higher education level positively correlated with health anxiety. Skilled workers tend to have higher health anxiety than semiskilled workers. Patients with diagnosis of somatoform disorder and multiple diagnosis scored higher on health anxiety in both the settings.
Conclusion
Health anxiety appears to be common in psychiatry and neurology settings and needs further evaluation to understand its impact on consultation and health resource usages.
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Affiliation(s)
- Lakshmi Prabha
- Department of Psychiatry, Sri Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
| | - Sundarnag Ganjekar
- National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Vivek Gupta
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Geetha Desai
- National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Santosh K Chaturvedi
- National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
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Abstract
Illness anxiety disorder is a primary disorder of anxiety about having or developing a serious illness. The core feature is the cycle of worry and reassurance seeking regarding health, as opposed to a focus on relief of distress caused by somatic symptoms (as in Somatic Symptom Disorder). Clinically significant health anxiety is common, with estimates ranging up to 13% in the general adult population. There are evidence-based treatments, including psychopharmacology and cognitive behavioral therapy, that can significantly alleviate symptoms. An understanding of the core psychopathology and clinical features of illness anxiety disorder is essential to fostering a working alliance with patients with health anxiety, as is the maintenance of an empathic, curious, and nonjudgmental stance toward their anxiety. Collaboration between medical providers is essential to avoid the pitfalls of excess testing and medical treatment.
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Owens VA, Hadjistavropoulos HD, Schneider LH, Gullickson KM, Karin E, Titov N, Dear BF. Transdiagnostic, internet-delivered cognitive behavior therapy for depression and anxiety: Exploring impact on health anxiety. Internet Interv 2019; 15:60-66. [PMID: 30723691 PMCID: PMC6350228 DOI: 10.1016/j.invent.2019.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/15/2019] [Accepted: 01/15/2019] [Indexed: 11/17/2022] Open
Abstract
Health anxiety is associated with significant personal distress and economic cost; as such, widely available and effective treatment options are crucial. Several studies suggest that Internet-delivered cognitive behavior therapy (ICBT) programs that specifically target health anxiety are efficacious for this condition. However, no known studies have examined the impact of transdiagnostic ICBT, which emphasizes the acquisition of broad coping skills applicable to a variety of mental health concerns, on symptoms of health anxiety. The current study sought to explore changes in health anxiety symptoms by utilizing data available from a previously published study of 8-week transdiagnostic ICBT. Specifically, changes in symptoms of health anxiety in response to a transdiagnostic ICBT program that targeted broad symptoms of depression and anxiety, were examined in a subsample of individuals who endorsed elevated symptom scores on the Short Health Anxiety Inventory at pre-treatment (n = 72). Following treatment, large reductions in health anxiety symptoms (Cohen's d = 0.91; 20% improvement), depression (Cohen's d = 0.85; reduction = 38%), generalized anxiety (Cohen's d = 1.21; reduction = 42%), and disability (Cohen's d = 0.90; reduction = 35%) were reported. Furthermore, results showed that transdiagnostic ICBT was rated as acceptable to people with high health anxiety symptoms. Despite elevated pre-treatment health anxiety scores, email correspondence between clients and their therapist revealed very few mentions of health anxiety. These findings provide preliminary evidence for transdiagnostic ICBT for symptoms of health anxiety and suggest further research is warranted.
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Affiliation(s)
| | - Heather D. Hadjistavropoulos
- Department of Psychology, University of Regina, Regina, Canada
- Corresponding author at: University of Regina, Department of Psychology, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada.
| | | | | | - Eyal Karin
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - Nickolai Titov
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - Blake F. Dear
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
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Panda SP, Das RC, Srivastava K, Ratnam A, Sharma N. Psychiatric comorbidity in multiple sclerosis. Neurol Neurochir Pol 2018; 52:704-709. [PMID: 30274945 DOI: 10.1016/j.pjnns.2018.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/19/2018] [Accepted: 09/09/2018] [Indexed: 11/19/2022]
Abstract
AIM To study the prevalence of psychiatric comorbidities in patients of multiple sclerosis and their association to the degree of disability. METHOD Psychiatric symptoms were assessed in 90 patients of multiple sclerosis using GHQ-12, MMSE, HADS, Beck Depression Inventory and AUDIT. Neurological disability was assessed using Expanded Disability Status Scale. Correlations were determined between EDSS scores and psychiatric scale scores. RESULT 61% of patients had significant psychological distress. Depression was most common (38.8%) which was followed by anxiety symptoms (27.8%). Cognitive functioning was relatively intact in patients with mild to moderate neurological disability. Alcohol abuse was mostly restricted to male gender. CONCLUSION Psychiatric illness is highly prevalent in patients of multiple sclerosis leading to poor quality of life and significant distress. Psychiatric disability was higher in patients who had greater deterioration in neurological function. All cases of MS should be assessed for psychiatric morbidities as can be alleviated by appropriate intervention.
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Affiliation(s)
- S P Panda
- Department of Psychiatry, Armed Forces Medical College (AFMC), Sholapur Road, Pune 411040, Maharashtra, India.
| | - R C Das
- Department of Psychiatry, Armed Forces Medical College (AFMC), Sholapur Road, Pune 411040, Maharashtra, India
| | - Kalpana Srivastava
- Department of Psychiatry, Armed Forces Medical College (AFMC), Sholapur Road, Pune 411040, Maharashtra, India
| | - Ashutosh Ratnam
- Department of Psychiatry, Armed Forces Medical College (AFMC), Sholapur Road, Pune 411040, Maharashtra, India
| | - Neha Sharma
- Department of Psychiatry, Armed Forces Medical College (AFMC), Sholapur Road, Pune 411040, Maharashtra, India
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Diagnostic Overshadowing of Anxiety in Parkinson Disease: Psychosocial Factors and a Cognitive-Behavioral Model. Cogn Behav Neurol 2018; 31:123-132. [DOI: 10.1097/wnn.0000000000000161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Oliver AM, Wright KD, Kakadekar A, Pharis S, Pockett C, Bradley TJ, Tomczak CR, Erlandson MC. Health anxiety and associated constructs in children and adolescents with congenital heart disease: A CHAMPS cohort study. J Health Psychol 2018; 25:1355-1365. [PMID: 29402140 DOI: 10.1177/1359105318755263] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study explored health anxiety and associated constructs in children and adolescents with congenital heart disease and typically developing children and adolescents. A total of 84 participants (7-16 years) completed measures of health anxiety, intolerance of uncertainty, anxiety sensitivity, and DSM-IV anxiety disorder symptom categories. Results demonstrated that children and adolescents with congenital heart disease experienced significantly higher levels of health anxiety and associated constructs compared to typically developing children and adolescents. Our findings highlight a specific chronic physical health population who may be at risk of clinical levels of health anxiety and related psychopathology and require appropriate intervention.
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The Impact of Health Anxiety in Multiple Sclerosis: A Replication and Treatment Case Series. Behav Cogn Psychother 2017; 46:148-167. [PMID: 28988546 DOI: 10.1017/s135246581700056x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is commonly associated with psychological complications. Previous research by Hayter and colleagues (2016) found that in patients with MS, health anxiety (HA) can account for part of the variance in quality of life (QoL) independent of physical and cognitive impairment caused by the disease. MS patients with HA perceived their intact physical and cognitive performance as impaired relative to those without HA and attributed the impairment to MS. These misperceptions might be useful targets in the treatment of HA in MS using cognitive behaviour therapy (CBT). AIMS Study 1 sought to replicate the main findings from Hayter et al. (2016). Study 2 examined the impact of HA-focused CBT in a case series. METHOD In Study 1, twenty participants with MS were screened for HA and assigned to either a high or low HA group. They completed assessments of cognitive and physical functioning before rating their performance on these tasks, followed by measures of QoL, mood and physical disability. Four participants in the high HA group subsequently received six sessions of CBT using a consecutive AB case series in Study 2. RESULTS Study 1 replicated the main findings from the earlier study. In Study 2, three of the four patients who received treatment showed substantial improvements in HA and mood and all showed improvement in QoL. CONCLUSION Given the high rates of HA in MS patients and its impact on QoL, this case series suggests that a brief CBT intervention could significantly improve patients' wellbeing.
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Bardeen JR, Fergus TA. Multidimensional Inventory of Hypochondriacal Traits: An Examination of a Bifactor Model and Measurement Invariance Between Those With and Without a Self-Reported Medical Condition. Assessment 2017; 27:206-215. [PMID: 28800717 DOI: 10.1177/1073191117725173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Multidimensional Inventory of Hypochondriacal Traits (MIHT) is a self-report measure that assesses four interrelated domains of health anxiety (i.e., Cognitive, Behavioral, Perceptual, Affective). Prior research has supported a correlated four-factor model, as well as a hierarchical model, in which each of the four factors load onto the higher order health anxiety construct. However, a bifactor modeling approach has yet to be used to examine the factor structure of the MIHT. Results supported a bifactor model of the MIHT in three different samples (i.e., unselected based on current medical status [n = 824], and those with [n = 348] and without [n = 354] a self-reported medical condition). The MIHT appears to be strongly multidimensional, with three of the four subscales providing substantive value. Confirmatory factor analysis supported the configural and metric/scalar invariance of the bifactor model between those with and without a self-reported medical condition. Results provide support for a bifactor conceptualization of the MIHT and the invariance of that model across levels of current health status.
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Grech LB, Kiropoulos LA, Kirby KM, Butler E, Paine M, Hester R. Executive function is an important consideration for coping strategy use in people with multiple sclerosis. J Clin Exp Neuropsychol 2017; 39:817-831. [PMID: 28092209 DOI: 10.1080/13803395.2016.1270907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Executive function deficits are prevalent in people with multiple sclerosis (PwMS), and PwMS use less adaptive coping than healthy controls. This cross-sectional study assessed whether there is a relationship between executive function and coping in PwMS. METHOD One hundred and seven participants with relapsing remitting or secondary progressive MS (n = 83 and 24, respectively; age M = 48.8 ± 11.1 years) completed measures of coping and executive function. RESULTS A positive relationship was found between verbal fluency and use of active, emotional, and instrumental social support coping, and total executive function and substance abuse coping. There was a negative relationship between coping strategies and core (social support, acceptance, religion, restraint, and total coping), higher order (denial and humor), and total executive function indices (acceptance, religion, behavioral disengagement, denial, and total coping). CONCLUSION These directional differences provide support for the importance of specific executive functions in coping strategy utilization. Understanding these relationships will assist psychologists and neuropsychologists with patient psychoeducation, adaptive coping strategy intervention and management for PwMS with reduced executive function ability.
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Affiliation(s)
- Lisa B Grech
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , VIC , Australia
| | - Litza A Kiropoulos
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , VIC , Australia
| | - Katherine M Kirby
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , VIC , Australia
| | - Ernest Butler
- b Department of Neurology , Monash Medical Centre , Clayton , VIC , Australia
| | - Mark Paine
- c Department of Neurology , St. Vincent's Hospital , Fitzroy , VIC , Australia
| | - Robert Hester
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , VIC , Australia
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Prevalence of depression and anxiety in Multiple Sclerosis: A systematic review and meta-analysis. J Neurol Sci 2017; 372:331-341. [DOI: 10.1016/j.jns.2016.11.067] [Citation(s) in RCA: 303] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 11/25/2016] [Accepted: 11/28/2016] [Indexed: 11/23/2022]
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A systematic review of anxiety amongst people with Multiple Sclerosis. Mult Scler Relat Disord 2016; 10:145-168. [PMID: 27919483 DOI: 10.1016/j.msard.2016.10.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/05/2016] [Accepted: 10/10/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic neurological disease, which poses significant psychological challenges. The purpose of this systematic review was to identify factors that are associated with anxiety in people with MS (PwMS). It aimed to examine the strength of evidence for factors associated with anxiety symptoms and identify limitations of existing studies. METHOD AND RESULTS One hundred and thirty one studies met inclusion criteria and were included in the review. A narrative synthesis was then conducted. Anxiety was found to be associated with a variety of demographic, physical, psychological, cognitive and social factors. A consistent finding was that anxiety was strongly associated with both high level of disability and low quality of life. A strong association between anxiety and depression was also found. CONCLUSION Implications for these results are discussed and a preliminary model of understanding anxiety in the context of MS is outlined. Given the overlap between anxiety and depression, a transdiagnostic treatment approach is suggested. In light of the shortcomings of extant studies, suggestions for future research are offered.
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Parkerson HA, Kehler MD, Sharpe D, Hadjistavropoulos HD. Coping with Multiple Sclerosis Scale: Reconsideration of the Factorial Structure. Int J MS Care 2016; 18:192-200. [PMID: 27551244 DOI: 10.7224/1537-2073.2015-031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Coping with Multiple Sclerosis Scale (CMSS) was developed to assess coping strategies specific to multiple sclerosis (MS). Despite its wide application in MS research, psychometric support for the CMSS remains limited to the initial factor analytic investigation by Pakenham in 2001. METHODS The current investigation assessed the factor structure and construct validity of the CMSS. Participants with MS (N = 453) completed the CMSS, as well as measures of disability related to MS (Multiple Sclerosis Impact Scale), quality of life (World Health Organization Quality of Life Brief Scale), and anxiety and depression (Hospital Anxiety and Depression Scale). RESULTS The original factor structure reported by Pakenham was a poor fit to the data. An alternate seven-factor structure was identified using exploratory factor analysis. Although there were some similarities with the existing CMSS subscales, differences in factor content and item loadings were found. Relationships between the revised CMSS subscales and additional measures were assessed, and the findings were consistent with previous research. CONCLUSIONS Refinement of the CMSS is suggested, especially for subscales related to acceptance and avoidance strategies. Until further research is conducted on the revised CMSS, it is recommended that the original CMSS continue to be administered. Clinicians and researchers should be mindful of lack of support for the acceptance and avoidance subscales and should seek additional scales to assess these areas.
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Hayter AL, Salkovskis PM, Silber E, Morris RG. The impact of health anxiety in patients with relapsing remitting multiple sclerosis: Misperception, misattribution and quality of life. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2016; 55:371-386. [PMID: 26806805 DOI: 10.1111/bjc.12106] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 12/11/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Multiple sclerosis (MS) is a progressive disease with an unpredictable prognosis. Previous studies have reported health anxiety within the MS population. This study examines the effect of health anxiety on MS patients' quality of life (QoL) and evaluates the potential contribution of cognitive factors in maintaining health anxiety. METHODS A total of 84 patients with relapsing remitting multiple sclerosis (RRMS) were screened for health anxiety. From this sample, a group with relatively high and another group with low anxiety (n = 21 in each group) were identified. A further 21 healthy controls were recruited for comparison. A measure of QoL was then completed. Cognitive biases were investigated by measuring perception and attribution of common bodily symptoms as well as appraisal of performance on neuropsychological and physical fatigue tests. RESULTS The high health anxiety group reported poorer QoL relative to the other groups, independent of level of disability. They were also more likely to misattribute common bodily changes to MS, and perceive their (objectively intact) performance on tests of cognition and fatigue as being impaired, attributing the cause of impairment to MS. CONCLUSION Health anxiety may be a factor in mediating the psychosocial impact of MS. Skilled psychological treatment which changes misperception and misattribution may significantly benefit patients with MS and elevated health anxiety. PRACTITIONER POINTS Clinical implications Health anxiety impacts on quality of life in patients with MS even when disability and other measures of psychological distress are taken into account. High levels of health anxiety distort perceptions of symptoms in patients with MS in line with the predictions made by the cognitive model of health anxiety. Limitations of study This study is limited to patients with RRMS within the relatively early stages of their disease and is based on a small sample size. Health anxiety is correlated with measures of generalized anxiety, depression, and worry, although it is found to have a unique impact on quality of life in patients with MS.
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Affiliation(s)
- Aimee L Hayter
- Department of Psychology, King's College, Institute of Psychiatry, London, UK.
| | | | - Eli Silber
- King's College Hospital NHS Foundation Trust, London, UK
| | - Robin G Morris
- Department of Psychology, King's College, Institute of Psychiatry, London, UK
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Do Flexible Goal Adjustment and Acceptance Help Preserve Quality of Life in Patients with Multiple Sclerosis? Int J Behav Med 2015; 23:333-339. [DOI: 10.1007/s12529-015-9519-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Delparte CA, Wright KD, Walker JR, Feldgaier S, Furer P, Reiser SJ, Sharpe D. Confirmatory Factor Analysis of the Childhood Illness Attitude Scales. CHILDRENS HEALTH CARE 2015. [DOI: 10.1080/02739615.2014.948158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Zhang Y, Liu R, Li G, Mao S, Yuan Y. The reliability and validity of a Chinese-version Short Health Anxiety Inventory: an investigation of university students. Neuropsychiatr Dis Treat 2015; 11:1739-47. [PMID: 26213472 PMCID: PMC4509540 DOI: 10.2147/ndt.s83501] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Short Health Anxiety Inventory (SHAI) is widely used in English-speaking populations, with good reliability and validity. For further research needs in the Chinese population, it was translated into a Chinese version (CSHAI). Furthermore, the reliability, validity, and cutoff score were examined in a nonclinical population in the People's Republic of China. METHODS Three hundred and sixteen undergraduates were evaluated by a set of questionnaires including CSHAI, Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), and the State-Trait Anxiety Inventory (STAI). Fifty-eight students completed CSHAI again after 30 days. RESULTS The two-factor model had satisfactory fit indices. The correlation coefficients between each item with the CSHAI total and each subscale were between 0.386 and 0.779. The Cronbach's alpha coefficients of CSHAI total and its subscales were 0.742, 0.743, and 0.788, respectively, and the split-half coefficients were 0.757, 0.788, and 0.912. The test-retest correlation coefficients were, respectively, 0.598 (P<0.001), 0.539 (P<0.001), and 0.691 (P<0.001). Convergent validities were respectively 0.389-0.453, 0.389-0.410, and 0.250-0.401, and discriminant validities were -5.689 (P<0.001), -5.614 (P<0.001), and -3.709 (P<0.001). The cutoff score was 15. CONCLUSION CSHAI showed good factor structure, reliability, convergent validity, and discriminant validity, and 15 was determined to be the appropriate cutoff score for screening health anxiety.
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Affiliation(s)
- Yuqun Zhang
- Department of Psychosomatics and Psychiatry, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, People’s Republic of China
| | - Rui Liu
- Information Science and Engineering School of Southeast University, Nanjing, People’s Republic of China
| | - Guohong Li
- Nursing Department, Affiliated Zhongda Hospital, Medical School of Southeast University, Nanjing, People’s Republic of China
| | - Shengqin Mao
- Department of Psychosomatics and Psychiatry, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, People’s Republic of China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, People’s Republic of China
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LeBouthillier DM, Thibodeau MA, Alberts NM, Hadjistavropoulos HD, Asmundson GJG. Do people with and without medical conditions respond similarly to the short health anxiety inventory? An assessment of differential item functioning using item response theory. J Psychosom Res 2015; 78:384-90. [PMID: 25592160 DOI: 10.1016/j.jpsychores.2014.12.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 12/22/2014] [Accepted: 12/23/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Individuals with medical conditions are likely to have elevated health anxiety; however, research has not demonstrated how medical status impacts response patterns on health anxiety measures. Measurement bias can undermine the validity of a questionnaire by overestimating or underestimating scores in groups of individuals. We investigated whether the Short Health Anxiety Inventory (SHAI), a widely-used measure of health anxiety, exhibits medical condition-based bias on item and subscale levels, and whether the SHAI subscales adequately assess the health anxiety continuum. METHODS Data were from 963 individuals with diabetes, breast cancer, or multiple sclerosis, and 372 healthy individuals. Mantel-Haenszel tests and item characteristic curves were used to classify the severity of item-level differential item functioning in all three medical groups compared to the healthy group. Test characteristic curves were used to assess scale-level differential item functioning and whether the SHAI subscales adequately assess the health anxiety continuum. RESULTS Nine out of 14 items exhibited differential item functioning. Two items exhibited differential item functioning in all medical groups compared to the healthy group. In both Thought Intrusion and Fear of Illness subscales, differential item functioning was associated with mildly deflated scores in medical groups with very high levels of the latent traits. Fear of Illness items poorly discriminated between individuals with low and very low levels of the latent trait. CONCLUSIONS While individuals with medical conditions may respond differentially to some items, clinicians and researchers can confidently use the SHAI with a variety of medical populations without concern of significant bias.
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Safi SZ. A Fresh Look at the Potential Mechanisms of Progressive Muscle Relaxation Therapy on Depression in Female Patients With Multiple Sclerosis. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2015; 9:e340. [PMID: 26251663 PMCID: PMC4525452 DOI: 10.17795/ijpbs340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/28/2014] [Accepted: 01/21/2015] [Indexed: 11/25/2022]
Abstract
Background: According to the World Health Organization (WHO) report released in 2000, about 121 million people worldwide suffer from depression. The major depressive disorder (MDD) among multiple sclerosis (MS) patients is one of the most common mood disorders experienced during life. MS patients who simultaneously suffer from depression have reported more severe symptoms of disease and slower adaptation to new conditions, which ultimately increase the cost of treatment. Objectives: The aim of this study was to assess the effectiveness of progressive muscle relaxation therapy (PMRT) as an adjunctive therapy for reducing level of depression for MS patients. Materials and Methods: This research had the randomized controlled trial design with pre and posttest. Thirty female patients based on criteria of MS and MDD disease, were selected from the MS Society of Shiraz, Iran. Beck Depression Inventory (BDI-II) was administered at pre and posttest. The participants were randomly allocated to two groups (experimental and control). Twelve sessions of PMRT using Bernstein and Borkovec’s method were held for the experimental group. Levin’s test, covariance and ANOVA with repeated measures were used for data analysis. Results: Experimental and control groups were compared before and after treatment. Analysis of covariance showed that seven levels of depression decreased in the experimental group and analysis of repeated measure showed that 49% of the changes were related to PMRT. Conclusion: According to the results, PMRT is effective in reducing depression. This therapy enables patients to reach relaxation quickly, and thus can cope with depression reactions effectively.
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A Fresh Look at the Potential Mechanisms of Progressive Muscle Relaxation Therapy on Depression in Female Patients With Multiple Sclerosis. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2015. [DOI: 10.5812/ijpbs.340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Marrie RA, Cohen J, Stuve O, Trojano M, Sørensen PS, Reingold S, Cutter G, Reider N. A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis: overview. Mult Scler 2015; 21:263-81. [PMID: 25623244 PMCID: PMC4361468 DOI: 10.1177/1352458514564491] [Citation(s) in RCA: 246] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Comorbidity is an area of increasing interest in multiple sclerosis (MS). Objective: The objective of this review is to estimate the incidence and prevalence of comorbidity in people with MS and assess the quality of included studies. Methods: We searched the PubMed, SCOPUS, EMBASE and Web of Knowledge databases, conference proceedings, and reference lists of retrieved articles. Two reviewers independently screened abstracts. One reviewer abstracted data using a standardized form and the abstraction was verified by a second reviewer. We assessed study quality using a standardized approach. We quantitatively assessed population-based studies using the I2 statistic, and conducted random-effects meta-analyses. Results: We included 249 articles. Study designs were variable with respect to source populations, case definitions, methods of ascertainment and approaches to reporting findings. Prevalence was reported more frequently than incidence; estimates for prevalence and incidence varied substantially for all conditions. Heterogeneity was high. Conclusion: This review highlights substantial gaps in the epidemiological knowledge of comorbidity in MS worldwide. Little is known about comorbidity in Central or South America, Asia or Africa. Findings in North America and Europe are inconsistent. Future studies should report age-, sex- and ethnicity-specific estimates of incidence and prevalence, and standardize findings to a common population.
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Affiliation(s)
- Ruth Ann Marrie
- Department of Internal Medicine, University of Manitoba, Canada/Department of Community Health Sciences, University of Manitoba, Health Sciences Center, Canada
| | - Jeffrey Cohen
- Mellen Center for MS Treatment and Research, Cleveland Clinic, USA
| | - Olaf Stuve
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern, USA
| | - Maria Trojano
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy
| | | | | | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham, USA
| | - Nadia Reider
- Department of Internal Medicine, University of Manitoba, Canada
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Marrie RA, Reingold S, Cohen J, Stuve O, Trojano M, Sorensen PS, Cutter G, Reider N. The incidence and prevalence of psychiatric disorders in multiple sclerosis: a systematic review. Mult Scler 2015; 21:305-17. [PMID: 25583845 PMCID: PMC4429164 DOI: 10.1177/1352458514564487] [Citation(s) in RCA: 316] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Psychiatric comorbidity is associated with lower quality of life, more fatigue, and reduced adherence to disease-modifying therapy in multiple sclerosis (MS). OBJECTIVES The objectives of this review are to estimate the incidence and prevalence of selected comorbid psychiatric disorders in MS and evaluate the quality of included studies. METHODS We searched the PubMed, PsychInfo, SCOPUS, and Web of Knowledge databases and reference lists of retrieved articles. Abstracts were screened for relevance by two independent reviewers, followed by full-text review. Data were abstracted by one reviewer, and verified by a second reviewer. Study quality was evaluated using a standardized tool. For population-based studies we assessed heterogeneity quantitatively using the I² statistic, and conducted meta-analyses. RESULTS We included 118 studies in this review. Among population-based studies, the prevalence of anxiety was 21.9% (95% CI: 8.76%-35.0%), while it was 14.8% for alcohol abuse, 5.83% for bipolar disorder, 23.7% (95% CI: 17.4%-30.0%) for depression, 2.5% for substance abuse, and 4.3% (95% CI: 0%-10.3%) for psychosis. CONCLUSION This review confirms that psychiatric comorbidity, particularly depression and anxiety, is common in MS. However, the incidence of psychiatric comorbidity remains understudied. Future comparisons across studies would be enhanced by developing a consistent approach to measuring psychiatric comorbidity, and reporting of age-, sex-, and ethnicity-specific estimates.
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Affiliation(s)
- Ruth Ann Marrie
- Department of Internal Medicine, University of Manitoba, Canada/Department of Community Health Sciences, University of Manitoba, Canada
| | | | - Jeffrey Cohen
- Mellen Center for MS Treatment and Research, Cleveland Clinic, USA
| | - Olaf Stuve
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern, USA
| | - Maria Trojano
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy
| | | | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham, USA
| | - Nadia Reider
- Department of Community Health Sciences, University of Manitoba, Canada
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Bot AGJ, Becker SJE, Bruijnzeel H, Mulders MAM, Ring D, Vranceanu AM. Creation of the Abbreviated Measures of the Pain Catastrophizing Scale and the Short Health Anxiety Inventory: The PCS-4 and SHAI-5. ACTA ACUST UNITED AC 2014. [DOI: 10.3109/10582452.2014.883020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Rief W, Martin A. How to Use the New DSM-5 Somatic Symptom Disorder Diagnosis in Research and Practice: A Critical Evaluation and a Proposal for Modifications. Annu Rev Clin Psychol 2014; 10:339-67. [DOI: 10.1146/annurev-clinpsy-032813-153745] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Winfried Rief
- Department of Psychology, Philipps University of Marburg, D-35032 Marburg, Germany;
| | - Alexandra Martin
- Faculty of Educational and Social Science, University of Wuppertal, D-42097 Wuppertal, Germany;
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Toosy A, Ciccarelli O, Thompson A. Symptomatic treatment and management of multiple sclerosis. HANDBOOK OF CLINICAL NEUROLOGY 2014; 122:513-562. [PMID: 24507534 DOI: 10.1016/b978-0-444-52001-2.00023-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The range of symptoms which occur in multiple sclerosis (MS) can have disabling functional consequences for patients and lead to significant reductions in their quality of life. MS symptoms can also interact with each other, making their management challenging. Clinical trials aimed at identifying symptomatic therapies have generally been poorly designed and have tended to be underpowered. Therefore, the evidence base for the management of MS symptoms with pharmacologic therapies is not strong and tends to rely upon open-label studies, case reports, and clinical trials with small numbers of patients and poorly validated clinical outcome measures. Recently, there has been a growing interest in the management of MS symptoms with pharmacologic treatments, and better-designed, randomized, double-blind, controlled trials have been reported. This chapter will describe the evidence base predominantly behind the various pharmacologic approaches to the management of MS symptoms, which in most, if not all, cases, requires multidisciplinary input. Drugs routinely recommended for individual symptoms and new therapies, which are currently in the development pipeline, will be reviewed. More interventional therapies related to symptoms that are refractory to pharmacotherapy will also be discussed, where relevant.
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Affiliation(s)
- Ahmed Toosy
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London, UK
| | - Olga Ciccarelli
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London, UK
| | - Alan Thompson
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London, UK.
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Diagnostik der Hypochondrie. PSYCHOTHERAPEUT 2013. [DOI: 10.1007/s00278-013-1011-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bourgault-Fagnou MD, Hadjistavropoulos HD. A Randomized Trial of Two Forms of Cognitive Behaviour Therapy for an Older Adult Population with Subclinical Health Anxiety. Cogn Behav Ther 2013. [DOI: 10.1080/16506073.2012.717302] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sarısoy G, Terzi M, Gümüş K, Pazvantoğlu O. Psychiatric symptoms in patients with multiple sclerosis. Gen Hosp Psychiatry 2013; 35:134-40. [PMID: 23260339 DOI: 10.1016/j.genhosppsych.2012.10.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 10/08/2012] [Accepted: 10/17/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This study was intended to identify general psychiatric symptoms in multiple sclerosis (MS) patients and to determine the distribution of these psychiatric symptoms by type of MS and degree of disability. METHODS One hundred fifty-two volunteers, 76 MS patients and 76 healthy controls, matched in terms of age, gender, marital status, years spent in education and income, were included. Psychiatric symptoms were measured using the Symptom Checklist-90-R, Beck Depression Inventory, State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, Padua Inventory, Rosenberg Self-Esteem Scale and Eating Attitude Test. Degree of disability was determined using the Expanded Disability Status Scale (EDSS). In addition to being compared between the patient and control groups, scale scores were also compared between groups established on the basis of relapsing-remitting or progressive forms of MS, neurological disability and ambulatory ability. Correlations were determined between EDSS scores and psychiatric scale scores. RESULTS In addition to symptoms of depression, anxiety and sleep impairment in MS patients, we also determined that less studied symptoms such as somatization, obsession, compulsion, interpersonal sensitivity, anger-hostility, phobic anxiety, paranoid ideation, psychoticism, low self-esteem and distorted eating attitudes were also more frequent compared to the healthy controls. Some symptoms were also more prevalent in progressive MS patients compared to relapsing-remitting subjects. Symptoms increase as degree of disability rises and ambulatory capacity declines. CONCLUSION Depressive, anxious and sleep impairment symptoms are not the only ones seen in MS patients; other psychiatric symptoms are also common. Further studies are needed to investigate the frequency and causes of these little-investigated symptoms. As seen in patients with a progressive course and greater neurological disability, more psychiatric symptoms develop in patients with more severe disease.
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Affiliation(s)
- Gökhan Sarısoy
- Ondokuz Mayis University School of Medicine Samsun/Turkey.
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Janzen Claude JA, Hadjistavropoulos HD, Friesen L. Exploration of health anxiety among individuals with diabetes: Prevalence and implications. J Health Psychol 2013; 19:312-22. [DOI: 10.1177/1359105312470157] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Health anxiety has been infrequently examined in individuals with diabetes. In this study, individuals with Type 1 or 2 diabetes ( n = 414) completed questionnaires assessing health anxiety and related constructs. Elevated health anxiety was reported by 24.1 percent of the sample and was greater among younger individuals, females, unmarried participants, and those recently diagnosed with diabetes. The construct was related to trait anxiety, fear of diabetes complications, poorer adherence to dietary and exercise self-care activities as well as lower physical quality of life. The research improves our understanding of health anxiety among individuals with diabetes.
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Alberts NM, Sharpe D, Kehler MD, Hadjistavropoulos HD. Health anxiety: comparison of the latent structure in medical and non-medical samples. J Anxiety Disord 2011; 25:612-4. [PMID: 21354766 DOI: 10.1016/j.janxdis.2011.01.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 01/28/2011] [Accepted: 01/28/2011] [Indexed: 11/30/2022]
Abstract
The Short Health Anxiety Inventory (SHAI; Salkovskis, Rimes, Warwick, & Clark, 2002) is a self-report measure designed to assess health anxiety in both medical and non-medical samples. The invariance of the factor structure across these samples has not been examined in the 14-item version of the SHAI. In the current study, the SHAI was completed by a community sample with no serious medical conditions (n=232) and a medical sample with multiple sclerosis (n=245). Factor analysis implied the same two-factor solution for both samples, with the two factors labelled: (1) Thought Intrusion, and (2) Fear of Illness. Item loadings were invariant across the medical and non-medical samples, but the two factors were more strongly correlated in the non-medical sample. Implications of the findings as well as directions for future research are discussed.
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Affiliation(s)
- Nicole M Alberts
- Department of Psychology, University of Regina, Regina, SK, Canada.
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Hadjistavropoulos HD, Janzen JA, Kehler MD, Leclerc JA, Sharpe D, Bourgault-Fagnou MD. Core cognitions related to health anxiety in self-reported medical and non-medical samples. J Behav Med 2011; 35:167-78. [DOI: 10.1007/s10865-011-9339-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Accepted: 03/21/2011] [Indexed: 11/24/2022]
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Weck F, Harms G, Neng JMB, Stangier U. Hypochondrische Merkmale bei Patienten einer psychotherapeutischen Ambulanz. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2011. [DOI: 10.1026/1616-3443/a000089] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Während die Hypochondrie eine relativ niedrige Prävalenz aufweist, gibt es Hinweise, dass hypochondrische Merkmale unterhalb der diagnostischen Schwelle deutlich häufiger vorliegen. Fragestellung: Wie häufig bestehen bei ambulanten Psychotherapiepatienten ausgeprägte hypochondrische Merkmale? Kann die hypochondrische Symptomatik durch bestehende somatische Krankheiten erklärt werden? Welche Risikofaktoren könnten bedeutsam sein? Methode: 85 Patienten einer psychotherapeutischen Ambulanz wurden hinsichtlich des Vorliegens hypochondrischer Merkmale, Krankheitserfahrungen und traumatischer Erfahrungen in der Kindheit untersucht. Ergebnisse: Je nach Cut-off-Kriterium zeigten sich bei 24–34% der Patienten ausgeprägte krankheitsbezogene Befürchtungen, die in geringem Umfang (6–10%) durch einen schlechteren Gesundheitsstatus erklärt werden konnten. Potenziell relevant für hypochondrische Symptome zeigte sich zudem die Anzahl verstorbener Familienangehöriger. Schlussfolgerung: Hypochondrische Merkmale sollten in der ambulanten psychotherapeutischen Versorgung eine größere Beachtung finden, da sie von den Patienten häufig berichtet werden.
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Affiliation(s)
- Florian Weck
- Goethe Universität Frankfurt, Abteilung Klinische Psychologie und Psychotherapie
| | - Gesa Harms
- Goethe Universität Frankfurt, Abteilung Klinische Psychologie und Psychotherapie
| | - Julia M. B. Neng
- Goethe Universität Frankfurt, Abteilung Klinische Psychologie und Psychotherapie
| | - Ulrich Stangier
- Goethe Universität Frankfurt, Abteilung Klinische Psychologie und Psychotherapie
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Fulton JJ, Marcus DK, Merkey T. Irrational health beliefs and health anxiety. J Clin Psychol 2010; 67:527-38. [DOI: 10.1002/jclp.20769] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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McDevitt-Murphy ME, Murphy JG, Monahan CM, Flood AM, Weathers FW. Unique Patterns of Substance Misuse associated with PTSD, Depression, and Social Phobia. J Dual Diagn 2010; 6:94-110. [PMID: 20582229 PMCID: PMC2891088 DOI: 10.1080/15504261003701445] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES: This study investigated the relations between post-trauma psychopathology and substance abuse in a sample of trauma-exposed college students (n = 136) assigned to four groups based on primary diagnosis: posttraumatic stress disorder, depression, social phobia, or well-adjusted (participants who had low levels of distress). Groups were compared on a series of dimensions of substance use/abuse. RESULTS: Participants in the PTSD group evidenced greater substance use and abuse than those in the social phobia and well-adjusted groups on several dimensions and greater alcohol consumption than the depressed group. Correlation analyses suggested that most dimensions of substance abuse were related more strongly to avoidance and numbing (cluster C) symptoms than to reexperiencing and hyperarousal. CONCLUSIONS: The present findings suggest that trauma-related psychopathology may be associated with a more hazardous pattern of substance use than depression and social phobia.
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Kowalyk KM, Hadjistavropoulos HD, Jones SL. What impact does pregnancy have on anxiety about health? J Psychosom Obstet Gynaecol 2009; 30:223-30. [PMID: 19863458 DOI: 10.3109/01674820903276453] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A previous study suggests that health anxiety, or preoccupation and fears about ill health, is elevated during pregnancy. However, replication of this result is needed given several methodological weaknesses of the previous research. The current study refined earlier work by assessing health anxiety using two distinct measures and comparing scores to a control group and to established norms for healthy controls. The relationship of health anxiety to background variables such as parity and pregnancy complications was also explored. METHODS A total of 252 women in the third trimester of pregnancy and 45 similarly aged non-pregnant women completed the Illness Attitudes Scale (IAS) and the newly developed Short Health Anxiety Inventory (SHAI). RESULTS Compared to the non-pregnant sample and established scores for healthy controls, health anxiety was not elevated during pregnancy. Health anxiety was higher in women who experienced complications during pregnancy but was unrelated to other background variables. The IAS identified more individuals as health anxious than the SHAI. CONCLUSIONS Contrary to previous research, health anxiety was not elevated during pregnancy. The IAS appeared to be susceptible to identifying women as health anxious due to greater health care utilization by pregnant women rather than higher health anxiety. Clinical recommendations and future directions for the assessment of health anxiety are outlined.
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Affiliation(s)
- Kristine M Kowalyk
- Regina Qu'Appelle Health Region, Functional Rehabilitation Program, Regina, Saskatchewan, Canada
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