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Barbek R, Henning S, Ludwig J, von dem Knesebeck O. Ethnic and migration-related inequalities in health anxiety: A systematic review and meta-analysis. Front Psychol 2022; 13:960256. [PMID: 36092037 PMCID: PMC9462455 DOI: 10.3389/fpsyg.2022.960256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Health anxiety exists on a continuum ranging from the absence of health awareness to the obsessive fear of having a serious illness despite reassurance. Its pathological manifestation can be diagnosed as hypochondriacal or illness anxiety or somatic symptom disorder. Health anxiety is associated with psychological distress and adverse life events, among others, and leads to considerable economic burden. Compared to the majority population, migrants, and ethnic minorities often face major health inequalities. Several mental illnesses and psychosomatic complaints are more common among these groups. To date, potential ethnic and migration-related inequalities in health anxiety have not been clearly described. However, they are of high relevance for the provision of adequate health care of this diverse and potentially vulnerable group. Thus, we conducted a systematic review and meta-analysis of health anxiety in migrants and ethnic minorities. Methods A systematic literature search of PubMED, Web of Science, PsycINFO, and PSYNDEX was conducted, covering all studies published until 1st of December 2021. Studies were selected if they employed validated measurement tools of health anxiety and examined migrants and/or ethnic minorities in comparison with the majority population. Meta-analytic methods were applied by using a random-effect model. The study quality was assessed with the Effective Public Health Practice Project Quality Assessment Tool (EPHPP). Results We identified 18 studies from 445 studies initially screened. Of these, 14 studies conducted in North America with a total number of 5,082 study participants were included in the meta-analysis. The pooled effect size indicated a higher risk of health anxiety in migrants and ethnic minorities compared to the majority population (OR 1.39, 95%-CI 1.01-1.92). The results proved not to be robust according to publication bias (adjusted OR 1.18, 95%-CI 0.83-1.69) and fail-safe N (2/3 < benchmark N = 75) and are limited due to heterogeneity (I 2 = 57%), small sample sizes and an overall low quality of included studies. Conclusion To address the diversity of migrants and ethnic minorities, inter-sectional approaches across different countries are needed in research to shed further light on social inequalities in health anxiety linked to migration. Systematic review registration PROSPERO, registration number CRD42022298458.
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Affiliation(s)
- Rieke Barbek
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Barbek RME, Makowski AC, von dem Knesebeck O. Social inequalities in health anxiety: A systematic review and meta-analysis. J Psychosom Res 2022; 153:110706. [PMID: 34954602 DOI: 10.1016/j.jpsychores.2021.110706] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The association between a low socioeconomic status and poor health, also known as social inequalities in health, has been shown in numerous studies. This also applies to most mental illnesses, such as somatization or anxiety disorders. It is unclear, however, whether social inequalities are evident in health anxiety as well. Therefore, this review and meta-analysis systematically examines social inequalities in health anxiety. METHODS A systematic literature search was conducted covering all studies published until August 2021. The databases PubMED, Web of Science, PsycINFO, and PSYNDEX were screened to identify quantitative studies using validated tools to measure health anxiety and examining the association with socioeconomic status. Meta-analytic methods were applied by using random-effect models. The study quality was assessed with the Effective Public Health Practice Project Quality Assessment Tool. RESULTS Overall, 37 studies were eligible for meta-analysis. Effect sizes of 27 studies using screening scales and 10 studies using diagnostic interviews to measure health anxiety were calculated separately. Meta-analyses revealed a significant association between socioeconomic status and health anxiety (r - 0.14, 95%-CI -0.18 to -0.09 (screening scales) and OR 0.63, 95%-CI 0.43 to 0.92 (diagnostic interviews)), indicating a lower risk for health anxiety in people with higher socioeconomic status. CONCLUSION Findings suggest that the health-related disadvantage of socially deprived people is also evident regarding health anxiety. This should be considered in programs to reduce social inequalities in health. PROSPERO registration number CRD42021237550.
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Affiliation(s)
- Rieke M E Barbek
- University Medical Center Hamburg-Eppendorf, Institute of Medical Sociology, Martinistraße 52, 20246 Hamburg, Germany.
| | - Anna Christin Makowski
- University Medical Center Hamburg-Eppendorf, Institute of Medical Sociology, Martinistraße 52, 20246 Hamburg, Germany.
| | - Olaf von dem Knesebeck
- University Medical Center Hamburg-Eppendorf, Institute of Medical Sociology, Martinistraße 52, 20246 Hamburg, Germany.
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Akariya O, Anholt GE, Shahar G. Is Self-Criticism Uniquely Associated with Health Anxiety among Jewish and Arab Israeli Young Adults? Int J Cogn Ther 2021. [DOI: 10.1007/s41811-021-00121-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Richardson A, Gurung G, Samaranayaka A, Gardner D, deGraaf B, Wyeth EH, Derrett S, Shepherd D, McBride D. Risk and protective factors for post-traumatic stress among New Zealand military personnel: A cross sectional study. PLoS One 2020; 15:e0231460. [PMID: 32303054 PMCID: PMC7164978 DOI: 10.1371/journal.pone.0231460] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 03/24/2020] [Indexed: 11/18/2022] Open
Abstract
Background Post-traumatic stress (PTS) is prevalent among military personnel. Knowledge of the risk and protective factors associated with PTS in this population may assist with identifying personnel who would benefit from increased or targeted support. Aims To examine factors associated with PTS among New Zealand military personnel. Methods For this cross-sectional study, currently serving and retired military personnel were invited to complete a questionnaire. The questionnaire included a measure of PTS (the Military Post-traumatic Stress Disorder Checklist; PCL-M), where scores ≥30 indicate the experience of significant PTS symptoms and scores ≥45 indicate a presumptive clinical diagnosis of post-traumatic stress. Potential risk and protective factors associated with PTS were examined using logistic regression modelling. Results 1817 military personnel completed the questionnaire. PCL-M scores were ≥30 for 549 (30%) participants and ≥45 for 179 (10%) participants. Factors associated with higher PCL-M scores were trauma exposure, older age, male sex, and Māori ethnicity. Factors associated with lower PCL-M scores were greater length of service, psychological flexibility, and better quality sleep. Conclusions PTS was found to be prevalent among New Zealand military personnel. The experience of trauma was strongly associated with PTS. However, factors such as psychological flexibility (the ability to adapt to changes in circumstances) and good sleep were protective, suggesting that these factors could be key targets for interventions designed to reduce PTS among military personnel in New Zealand.
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Affiliation(s)
- Amy Richardson
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Gagan Gurung
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Ari Samaranayaka
- Centre for Biostatistics, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Dianne Gardner
- School of Psychology, Massey University, Palmerston North, New Zealand
| | - Brandon deGraaf
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Emma H. Wyeth
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Daniel Shepherd
- Department of Psychology, Auckland University of Technology, Auckland, New Zealand
| | - David McBride
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- * E-mail:
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Taghva A, Allami M, Alizadeh K, Zandi A, Faraji E, Ganjparvar Z. Mental health among Iranian combat veterans with ankle-foot neuromusculoskeletal injuries. Mil Med Res 2017; 4:30. [PMID: 29502520 PMCID: PMC5613370 DOI: 10.1186/s40779-017-0138-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 08/31/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Veterans with purely physical disorders, such as ankle-foot neuromusculoskeletal disorders, are often neglected in psychological assessments because mental health evaluations are usually focused on those with a psychological disturbance or with a high percentage of injury. The purpose of this study was to evaluate the psychological condition of veterans with ankle-foot neuromusculoskeletal disorders. METHODS A cross-sectional study was performed between 2014 and 2016 on veterans with war-related ankle-foot injuries living in two provinces of Iran. An information form for demographic data and injury-related factors was used. Additionally, the previously validated Persian version of the Symptom Checklist-90-Revision (SCL-90-R) questionnaire was used for data collection. RESULTS The respondents were 215 male veterans with a mean age of 51.7 ± 7.5 years. The most common mental health problems were observed for the somatization (24.7%), obsessions-compulsions (14.4%), and anxiety (12.6%). Based on the Global Severity Index (GSI), 48.6% of individuals had a possible psychiatric/psychological illness. According to the multivariate regression analysis, GSI scores were significantly higher among veterans who were older than 27 years at the time of injury (P = 0.005), had an associated injury (P = 0.002), and had a history of hospitalization within the past 12 months for reasons other than their injury (P = 0.035). CONCLUSIONS Approximately half of the combat veterans with ankle-foot neuromusculoskeletal disorders likely had psychological problems. The evaluation of the patterns and predicting factors of psychological conditions may inform strategic planning efforts and decision-making, which, in turn, may provide a better quality of life for veterans. Further studies that utilize longitudinal designs are needed to evaluate and compare the psychological status of different groups of veterans and other groups in the general population.
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Affiliation(s)
- Arsia Taghva
- AJA University of Medical Sciences, Disaster and Military Psychiatry Research Center, Tehran, Iran
| | - Mostafa Allami
- Janbazan Medical and Engineering Research Center, Tehran, Iran
| | - Kamyab Alizadeh
- AJA University of Medical Sciences, Disaster and Military Psychiatry Research Center, Tehran, Iran
| | - Anahita Zandi
- Nursing and Midwifery Department, Torbat Heydarieh University of Medical Sciences, Torbat, Iran
| | - Elahe Faraji
- Janbazan Medical and Engineering Research Center, Tehran, Iran.
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Johnson SK, Blanchard A. Emotional Intelligence and Mental Health: Stress and Symptom Reporting Pathways. ACTA ACUST UNITED AC 2016. [DOI: 10.17744/mehc.38.1.06] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examines the pathways through which mood perception affects perceived stress and symptom reporting among undergraduate students. It examines depression, anxiety, positive affect, and negative affect as mediators between a) emotional intelligence (EI) and b) perceived stress and symptom reporting. Results indicated that on the EI measure used in this study, the Trait Meta-mood Scale (TMMS) subscales, Attention was not related to perceived stress or symptom reporting. Mood Repair and Clarity were significantly and inversely related to perceived stress and symptom reporting. Anxiety and depression were the primary mediators in these relationships.
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Zargar F, Foruzandeh E, Omidi A, Mohammadi A. Psychological health and marital adjustment in Iranian employed veterans and veterans receiving disability pension. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e10219. [PMID: 25237560 PMCID: PMC4166079 DOI: 10.5812/ircmj.10219] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 03/19/2013] [Accepted: 11/12/2013] [Indexed: 11/20/2022]
Abstract
Background: Human society has witnessed disasters and wars that left many consequences on families as well as social and individual life of the victims. Objectives: In this research, we compared the psychological health and marital adjustment in Iranian employed veterans with veterans receiving disability pension. Patients and Methods: The study participants were all of the veterans of Isfahan city registered in Veterans and Martyr Foundation who were receiving disability pension, were still working, or had not received any disability pension yet. A total of 330 veterans were selected by randomized systematic sampling. The Symptom Checklist-90-Revised (SCL-90-R) questionnaire and Dyadic Adjustment Scale (DAS) were completed by the participants. The data were analyzed by Chi square test, independent samples t test, and Mann-Whitney U test. Results: Almost half of the veterans did not demonstrate any psychopathology and half of them were diagnosed with borderline or serious psychopathology. Veterans receiving disability pension had more mental problems in comparison with the employed veterans. Veterans receiving disability pension had higher scores in psychosomatic disorders, obsessive-compulsive disorder, depression, anxiety, phobias, psychoticism, and total scales (general symptom index, GSI) in comparison with the employed veterans. Employed veterans and veterans receiving disability pension did not differ significantly regarding DAS scores. Conclusions: Occupational condition has an important effect on mental health of veterans.
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Affiliation(s)
- Fatemeh Zargar
- Department of Clinical Psychology, School of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Elham Foruzandeh
- Department of Psychology, Isfahan Science and Research Branch, Islamic Azad University, Isfahan, IR Iran
- Corresponding Author: Elham Forouzandeh, Department of Psychology, Isfahan Science and Research Branch, Islamic Azad University, Isfahan, IR Iran. Tel: +98-9132083174, Fax: +98-3615550111, E-mail:
| | - Abdollah Omidi
- Department of Clinical Psychology, School of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Abolfazl Mohammadi
- Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
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Boone KB. Fixed belief in cognitive dysfunction despite normal neuropsychological scores: neurocognitive hypochondriasis? Clin Neuropsychol 2009; 23:1016-36. [PMID: 18923966 DOI: 10.1080/13854040802441135] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A subset of patients who present for neuropsychological testing report dysfunction in daily life activities secondary to cognitive deficits, but are found on formal testing to have no objective abnormalities, raising the possibility of "neurocognitive hypochondriasis." Such a case is presented, and the factors that appear to give rise to this presentation are explored. Cases of hypochondriacal overconcern regarding cognitive function are likely not rare, particularly given research showing there is little correlation between objective report of cognitive dysfunction and actual test scores in such conditions as mild traumatic brain injury, chronic fatigue syndrome, fibromyalgia, toxic mold exposure, and post-polio syndrome.
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Affiliation(s)
- Kyle Brauer Boone
- Center for Forensic Studies, Alliant International University - LA, 1000 South Fremont Avenue, Alhambra, CA91803, USA.
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Abstract
BACKGROUND A long-standing issue in the health anxiety literature is the extent to which health anxiety is a dimensional or a categorical construct. This study explores this question directly using taxometric procedures. METHOD Seven hundred and eleven working adults completed an index of health anxiety [the Whiteley Index (WI)] and indicated their current health status. Data from those who were currently healthy (n=501) and receiving no medical treatment were examined using three taxometric procedures: mean above minus below a cut (MAMBAC), maximum eigenvalue (MAXEIGEN) and L-mode factor analysis (L-MODE). RESULTS Graphical representations (comparing actual to simulated data) and fit indices indicate that health anxiety is more accurately represented as a dimensional rather than a categorical construct. CONCLUSIONS Health anxiety is better represented as a dimensional construct. Implications for theory development and clinical practice are examined.
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Affiliation(s)
- E Ferguson
- Risk Analysis, Social Processes and Health (RASPH) Group, School of Psychology, University of Nottingham, UK.
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10
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Rapid avoidance acquisition in Wistar–Kyoto rats. Behav Brain Res 2008; 192:191-7. [DOI: 10.1016/j.bbr.2008.04.006] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2007] [Revised: 04/01/2008] [Accepted: 04/09/2008] [Indexed: 12/21/2022]
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Ferguson E. Health anxiety moderates the daytime cortisol slope. J Psychosom Res 2008; 64:487-94. [PMID: 18440401 DOI: 10.1016/j.jpsychores.2008.01.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2007] [Revised: 01/21/2008] [Accepted: 01/24/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Edwards et al. argue that a steeper daytime cortisol slope indicates increased symptom awareness [Edwards S, Hucklebridge F, Clow A, Evans P. Components of the diurnal cortisol cycle in relation to upper respiratory symptoms and perceived stress. Psychosom Med, 2003;65:320-7]. Theory suggests that health anxiety (HA) is associated with increased symptom awareness. Therefore, this study tests the hypothesis that higher levels of HA are associated with a steeper daytime cortisol slope and is the first to examine the daytime diurnal cortisol slope for HA. METHODS Forty-two healthy working adults completed measures of HA and neuroticism as well as indices to measure the severity and frequency of symptom reporting. Participants also provided eight consecutive days of salivary cortisol data. Two cortisol measures were taken each day -- once prior to lunch and once in the early evening -- the timing of these was synchronized to waking times. The data were analyzed using multilevel modeling. RESULTS The hypothesis was supported, with those scoring higher on HA showing a steeper daytime cortisol slope. There were no significant relationships between cortisol (average production and slope) and either neuroticism or symptom reporting (severity and frequency). CONCLUSIONS The results are interpreted as consistent with theories of HA that emphasis increased awareness of nonspecific symptoms.
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Affiliation(s)
- Eamonn Ferguson
- Risk Analysis, Social Processes and Health (RASPH) Group, School of Psychology, University of Nottingham, Nottingham, UK.
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Anxiety Sensitivity and Health Anxiety in a Nonclinical Sample: Specificity and Prospective Relations with Clinical Stress. COGNITIVE THERAPY AND RESEARCH 2008. [DOI: 10.1007/s10608-008-9188-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Forman-Hoffman VL, Peloso PM, Black DW, Woolson RF, Letuchy EM, Doebbeling BN. Chronic Widespread Pain in Veterans of the First Gulf War: Impact of Deployment Status and Associated Health Effects. THE JOURNAL OF PAIN 2007; 8:954-61. [PMID: 17704006 DOI: 10.1016/j.jpain.2007.07.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2007] [Revised: 06/28/2007] [Accepted: 07/02/2007] [Indexed: 11/20/2022]
Abstract
UNLABELLED Our study sought to 1) determine if deployment status is associated with chronic widespread pain (CWP), and 2) evaluate whether veterans with CWP have greater psychiatric comorbidity, higher health care utilization, and poorer health status than veterans without CWP. Five years after the conclusion of the first Gulf War (August 1990 to June 1991), we conducted a cross-sectional study of veterans who listed Iowa as the home of record using a stratified sampling design to determine their health status. We compared the prevalence of CWP between deployed and nondeployed veterans. Logistic and multiple linear regression models were constructed to test whether CWP was associated with comorbidities and health-related outcomes of interest. Five hundred ninety of 3695 veterans interviewed (16%) had CWP. Gulf deployment was associated with higher prevalence of CWP than deployment elsewhere (OR = 2.03, 95%CI = 1.60-2.58), after adjustment. Both deployed and nondeployed veterans with CWP reported more health care utilization and comorbidities and lower health-related quality of life scores than veterans without CWP. Deployed veterans were more likely to have CWP than nondeployed veterans, and CWP was associated with poor health outcomes. Military and medical personnel should be aware that efforts to prevent, identify, and treat CWP in veterans returning from the current war may be needed. PERSPECTIVE This article indicates that deployed veterans may have an increased risk for development of CWP, which is associated with greater healthcare utilization and comorbidity and lower quality of life. The risk of poor health outcomes suggests that veterans returning from the present conflict should be screened for CWP on their return.
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Affiliation(s)
- Valerie L Forman-Hoffman
- Center for Research in the Implementation of Innovative Strategies in Practice, Iowa City Veteran's Affairs Medical Center, Iowa City, Iowa 52242, USA.
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Hilty DM, Bourgeois JA, Chang CH. Diagnostic and treatment interventions for hypochondriasis in the neurology setting. Curr Treat Options Neurol 2006; 8:401-9. [PMID: 16901379 DOI: 10.1007/s11940-006-0029-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Many patients who present to neurology settings with somatic complaints have underlying fear of illness, anxiety, or depression. Hypochondriasis, which is one of the somatoform disorders, contributes to high use of services and frustration on the part of clinicians, because diagnostic and treatment interventions often fail. The challenges for clinicians include how to distinguish true somatic symptoms from those associated with fear or other psychiatric symptoms. Our goal is to provide the clinician with an integrated approach for the triage, assessment (history, screening tools, examination, and diagnostic tests), and treatment of these challenging patients. Recommendations are made regarding psychiatric consultation and comanagement between fields for complex patients.
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Affiliation(s)
- Donald M Hilty
- University of California, Davis, Department of Psychiatry, 2230 Stockton Boulevard, Sacramento, CA 95817, USA.
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Noyes R, Watson DB, Letuchy EM, Longley SL, Black DW, Carney CP, Doebbeling BN. Relationship between hypochondriacal concerns and personality dimensions and traits in a military population. J Nerv Ment Dis 2005; 193:110-8. [PMID: 15684913 DOI: 10.1097/01.nmd.0000152794.87100.92] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Our aim was to examine the relationship between personality dimensions and hypochondriacal concerns and somatic symptoms in a military population. The Schedule of Nonadaptive and Adaptive Personality along with measures of hypochondriacal concerns and somatic symptoms were administered to 602 military veterans who had been on active duty during the 1991 Gulf War. Factor analyses identified six separable dimensions-two of hypochondriacal concerns, two of somatic symptoms, and two of possible mechanisms of symptom generation-for study. Multiple regression models determined the proportion of variation in these measures of somatic distress explained by personality scales. Personality measures explained between 26% and 38% of the variance in hypochondriacal concerns and somatic symptoms, and Negative Temperament accounted for most of this. Moderately strong positive correlations were observed between trait scales Mistrust, Low Self-Esteem, and Eccentric Perceptions and the various measures of somatic distress. Thus, when Negative Temperament was taken into account, few significant correlations between personality measures and hypochondriacal concerns or somatic symptoms remained. Negative temperament or neuroticism is strongly associated with hypochondriacal concerns. Important features of hypochondriasis and somatic distress appear to lie within the domain of personality. It remains for future research to show whether negative temperament is a vulnerability factor for hypochondriasis or hypochondriasis is itself a personality disorder.
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Affiliation(s)
- Russell Noyes
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa 52242-100, USA
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