Prevalence of hypochondriac symptoms among health science students in China: A systematic review and meta-analysis

Health Anxiety, Fear of COVID-19, Nosophobia, and Health-protective Behaviors Among Healthcare Professionals

Objective

This study examined fear of COVID-19, nosophobia, health anxiety, and health-protective behaviors among healthcare professionals during the COVID-19 pandemic.

Methods

A cross-sectional, correlational research design was used in this study. The data of healthcare professionals (N=300) from three disciplines of medicine (Bachelor of Medicine and Bachelor of Surgery [MBBS], Bachelor of Dental Surgery [BDS], Doctor of Physiotherapy [DPT]) were collected using a purposive sampling technique. The Fear of COVID-19 Scale (FCV-19S), Medical Student Disease Perception and Distress Scale (MSD), Short Health Anxiety Inventory (SHAI), and Health Protective Behavior Scale (HBPS) were used as assessment measures. Statistical Package of Social Sciences (SPSS) version 22 was used to analyze the data obtained.

Results

Of the 300 participants, 132 (44%) were male and 168 (56%) were female. A total of 199 participants (63.3%) had a MBBS degree, 59 (19.7%) had a BDS degree, and 41 (14%) had a DPT degree. The findings revealed a significant positive correlation between nosophobia, health anxiety, and fear of COVID-19, whereas health-protective behavior showed a negative association with health anxiety. Sex, health anxiety, and nosophobia were significant predictors of health-protective behaviors among medical professionals.

Conclusion

The fear related to COVID-19 is associated with nosophobia and health anxiety among medical professionals, which has a substantial impact on health, work performance, and vulnerability to developing psychological distress if left unmonitored.

Depression and Anxiety among Undergraduate Health Science Students: A Scoping Review of the Literature

Background: Health science students in post-secondary institutions experience high levels of depression and anxiety due to increased stress levels, workload, low socioeconomic status, and history of family mental illness, among other factors. Given the significant negative impact that depression and anxiety can have on undergraduate health science students, it is essential to understand the prevalence and correlation of these conditions in this population. In light of this, this scoping review aims to identify, document, and analyze the literature on the prevalence and determinants of anxiety and depression among undergraduate health sciences students and identify gaps in knowledge for future research. Methods: This scoping review was planned and executed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for the Scoping Reviews statement. A comprehensive and systematic search was carried out for five databases, namely MEDLINE, Scopus, EMBASE, CINAHL, and PubMed. Results: From the literature identified by our search strategy, the lowest prevalence for anxiety was 5.8%, and the highest was 82.6%, with a median of 44.25%. The prevalence of depression ranged from a high of 88.8% to a low of 2.1%, with a median value of 34.8%. Our analysis revealed that correlates of anxiety and depression among health science students include sociodemographic factors such as age, sex, gender, relationships, ethnicity, and family history, personal health conditions, and academic and socioeconomic issues. Conclusions: With the high incidence of anxiety and depression among health science students, there is an increasing need to find practical remedies to support these students. It is also essential for policymakers and university authorities to implement interventions such as supportive text messages and other strategies geared toward providing support and improving the psychological well-being of health science students.

Illness Anxiety Disorder and Distress among Female Medical and Nursing Students

Objective

This study aims to compare the prevalence of illness anxiety disorder (IAD) and distress between medical and nursing students and examine their associations with students' characteristics.

Methods

Cross-sectional data were collected using the Short Health Anxiety Inventory (SHAI, for measuring IAD) and the Medical Students' Disease (MSD) Perception and Distress Scales.

Results

Two hundred and sixteen Medical students and 250 Nursing students were recruited from a public female university in Saudi Arabia. Their mean age was 21.27 years. The findings showed that the overall prevalence of IAD (SHAI scores ≥18) among the total sample was 38.8%, with a significantly lower prevalence in medical students compared to the prevalence in nursing students (57.2% vs 17.6%, respectively, X2=45.26, p<.001). Nursing students had significantly higher SHAI scores and lower MSD Perception scores than medical college students, but there were no significant differences among them in the MSD Distress scale. Significant differences in the main study variables scores were reported among nursing students but not among medical students, with the fourth-year level nursing students having higher SHAI and lower MSD Perception and perception scores than other nursing students.

Conclusion

The highlights that medical and nursing students are susceptible to developing anxiety-related disorders and distress that may have negative impacts on their academic achievements and future careers. Both nursing and medical faculty should help in identifying strategies to support the students' mental health and well-being.

Prevalence of the medical student syndrome among health professions students and its effects on their academic performance

Medical student syndrome (MSS) is health-related anxiety while studying a specific disease that leads to stress and anxiety. The study aims to determine the prevalence of MSS among health professions students to identify its effect on the student academic performance and to recognize the awareness of MSS among health professions students. This is a descriptive cross-sectional study where 544 students from King Saud University health colleges were included and filled in a self-reported designed questionnaire. We used validated scale of short health anxiety inventory closed-ended items to measure the prevalence of MSS. All statistical analyses were performed using the statistical package for social sciences statistical software package. The results showed that 8.5% of the health colleges students were affected by MSS. The students with the medical syndrome had higher levels of anxiety (anxiety-odd ratio [OR] = 1.3, P = .35; anxiety-OR = 1.57, P = .27) and hypochondriac issues (hypochondria-OR = 2.93, P = .03; hypochondria-OR = 2.61, P = .14) than other students. Concerning to MSS negative consequences, students who experienced medical syndrome most of the time and always were 1.43 and 1.45 times more likely to experience anxiety. As a result of the medical syndrome, students with a grade point average decrease of <0.20 are 3.37 times more likely to develop a hypochondriac problem than students with no grade point average decrease (OR = 3.37; P = .04). Third-year students reported more anxiety and hypochondria symptoms than other-year students. In conclusion, MSS is a growing problem in health colleges. This study showed that, academic performance was affected for the students who have MSS. The prevention of this phenomenon may be greatly enhanced by reassurance and discussions about this syndrome.

Can we trust computers to assess the cognition of stroke patients? A systematic review

Purpose

To summarize the classification of computerized cognitive assessment (CCA) tools for assessing stroke patients, to clarify their benefits and limitations, and to reveal strategies for future studies on CCA tools.

Methods

A literature review was performed using PubMed, Embase, Scopus, JAMA Network, Cochrane Library and PsycINFO databases from January 1st, 2010, to August 1st, 2022. Two authors independently screened the literature following the same criteria, evaluated the study quality, and collected data from the articles.

Results

A total of 8,697 papers were acquired from the six databases. A total of 74 potentially eligible articles were selected for review. Of these, 29 articles were not relevant to this research, 3 were reviews, 2 were not written in English, and 1 was on an ongoing trial. By screening the references of the reviews, 3 additional articles were included in this study. Thus, a total of 42 articles met the criteria for the review. In terms of the CCA tools analyzed in these studies, they included five types: virtual reality (VR)-based, robot-based, telephone-based, smartphone-based, and computer-based cognitive assessments. Patients' stages of the disease ranged from the subacute phase and rehabilitation phase to the community phase. A total of 27 studies supported the effectiveness of CCA tools, while 22 out of 42 articles mentioned their benefits and 32 revealed areas for future improvement of CCA tools.

Conclusions

Although the use of CCA tools for assessing the cognition of post-stroke patients is becoming popular, there are still some limitations and challenges of using such tools in stroke survivors. More evidence is thus needed to verify the value and specific role of these tools in assessing the cognitive impairment of stroke patients.

Medical Students' Syndrome among Medical Students in the University of Sharjah, UAE

Background  Medical students' syndrome (MSS) is a set of psychosomatic symptoms that affect students due to their medical background knowledge. Objectives  This study aims to measure the prevalence and assess the knowledge about MSS among medical students at the University of Sharjah. It also aims to compare the attributed characteristics of MSS between different years of study. Methods  A self-administered 24-item questionnaire was distributed to 503 students enrolled in the College of Medicine at University of Sharjah using nonprobability convenience sampling during June 2021. A total of 472 responses were completed and analyzed using descriptive studies and chi-squared test. Results  The prevalence of MSS in this study was found to be 70.8% ( n  = 334). Clinical year students were 1.75 times more likely to have felt they had a disease they studied about (95% confidence interval: 1.05-2.90, p  = 0.03). Conclusion  Medical students are more likely to experience MSS as their education progresses.

Evaluation of the prevalence of illness anxiety disorder following the COVID-19 pandemic in Iran and its related factors: a cross-sectional study

BACKGROUND AND AIMS

COVID-19 pandemic has generated a rise in psychological distress, such as illness anxiety disorder, apart from its negative physical effects. This study intends to the evaluation of illness anxiety disorder rate following the prevalence of COVID-19 in Iran and its associated factors.

METHODS

In this study, 634 people were studied. The data collection method was performed via the virtual networks using a questionnaire, with the sampling method being convenient and nonprobable with the method of snowball. Evans illness anxiety disorder questionnaire was utilized in this investigation. The logistic regression model and the χ 2 were used to evaluate the data.

RESULTS

The prevalence of illness anxiety disorder was 12.1%. The chance to have an illness anxiety disorder in the people whose relatives had a history of COVID-19 was 5.32 times, and in those who had a relative with a history of COVID-19 had higher (odds ratio = 1.27). But, this connection in people who worked or studied in nonmedical fields, is several times more than those who are busy in the medical fields. In individuals of 30 years and older, the chance of patients in single people compared to married people was 5.20 times higher, but under the age of 30 years, the chance of illness anxiety disorder in single people was 0.91.

CONCLUSION

COVID-19 pandemic, also to the physical effects, may have psychological implications for people. Therefore, reducing the individual and social activities in terms of this disease, along with measures related to physical problems, diagnosis, timely treatment and proper psychological consequences, including illness anxiety disorder can be very fruitful.

Hypochondriasis and self-medication among medical sciences students during the COVID-19 pandemic: A descriptive cross-sectional study in Northwestern Iran

BACKGROUND

Increased fear and anxiety among the general public following the emergence of coronavirus 2019 (COVID-19) can lead to hypochondriasis as well as indiscriminate use of drugs, versus the disease.

OBJECTIVE

The present study was conducted to identify the frequency and causes of self-medication and hypochondriasis among students.

METHODS

This descriptive cross-sectional study was conducted among 241 students of different disciplines of Khalkhal University of Medical Sciences in northwestern Iran over a period of six months. SPSS 26 software, Chi-square and Fisher tests were used to analyze the data.

RESULTS

The rate of self-medication was calculated 51%. The highest rate of self-medication was in the form of tablets (75.6%) and capsules (28.5%) and the highest type of medication was herbal medicine (59.3%) and multivitamins and complementary drugs (54.5%). The most common cause of self-medication was previous use and the effectiveness of the drug in the past (79.7%). The mean score of hypochondriasis was calculated at 21.52 (11.02) and the majority of students (49.8%) were in the healthy group. There was a statistically significant association between hypochondriasis and self-medication (p = 0.002).

CONCLUSION

Based on the findings, more than half of the participants in the study had self-medication. About 20% of students also experienced mild to moderate hypochondriasis. Therefore, it is suggested that the necessary training and support be provided to deal with the side effects of these two phenomena.

Meta-analysis of cognitive behaviour therapy and selective serotonin reuptake inhibitors for the treatment of hypochondriasis: Implications for trial design

BACKGROUND

Classification of hypochondriasis as an obsessive-compulsive and related disorder in the International Classification of Diseases 11th Revision (ICD-11) has generated new heuristics for treatment of this common, chronic and disabling disorder. Standard treatment involves cognitive behaviour therapy (CBT) or selective serotonin reuptake inhibitors (SSRIs), but no meta-analysis has so far considered hypochondriasis as a structured diagnosis or assessed the role of medication. A clearer understanding of the relative effectiveness of these interventions and identification of clinically relevant factors moderating the treatment response is needed for clinical guideline development.

METHODS

The current systematic review and meta-analysis of interventions for hypochondriasis was preregistered on PROSPERO (CRD42020185768) and follows PRISMA guidelines. We searched MEDLINE, PsycINFO, and Cochrane Library databases until July 2021 for randomized controlled trials (RCTs) of interventions for patients diagnosed with hypochondriasis (or historical diagnostic equivalents). We assessed aspects of study quality using: the CONSORT Checklist for evaluation of RCTs, the Cochrane Risk of Bias 2 tool, researcher allegiance and treatment fidelity. The primary outcome was improvement in hypochondriasis symptoms, comparing intervention and control groups at trial endpoint. Moderator variables were assessed using subgroup and meta-regression analyses.

RESULTS

Searches identified 13 randomised controlled trials (RCTs) (N = 1405); 12 included CBT (N = 1212) and three included SSRI (N = 193) arms as the experimental intervention. Random effects meta-analysis yielded a moderate-to-large effect size for CBT versus all controls (g = -0.70 [95% CI -0.99 to -0.41], k = 18, I² = 81.1%). Funnel plot asymmetry indicated possible publication bias and two potentially missing trials, reducing the effect size (g = -0.60 [95% CI -0.88 to -0.32]). Subgroup analysis showed that choice of control significantly moderated effect size, with those in CBT vs. wait-list (g = -1.32 [95% CI -1.75 to -0.90], k = 7, I² = 0%) being double those of CBT vs. psychological or pharmacological placebo controls (g = -0.58 [95% CI -0.95 to -0.22], k = 7, I² = 82%). Analysis of studies directly comparing CBT and SSRIs found a numerical, but not statistical advantage for SSRIs (g = 0.21 [95% CI -0.46 to 0.87], k = 2, I² = 58.34%) and a modest effect size emerged for SSRIs vs. pill placebo (g = -0.29 [95% CI -0.57 to -0.01], k = 3, I² = 0%). Most studies (11/13) were rated as high on potential researcher allegiance bias in favour of CBT. Meta-regressions revealed that effect sizes were larger in younger participants, and smaller in better quality and more recent RCTs and those with greater CBT fidelity.

CONCLUSION

CBT and SSRIs are effective in the acute treatment of hypochondriasis, with some indication that intervention at a younger age produces better outcomes for CBT. In the case of CBT, effect sizes appear to have been significantly inflated by the use of wait list controls, and researcher allegiance bias. We recommend that a definitive, adequately controlled trial, designed with respect to the methodological issues raised in this meta-analysis, is needed to determine the magnitude effects for CBT and SSRIs with confidence and the long-term effect of treatments, to inform mental health service provision for this overlooked patient group.

Factors associated with health anxiety in medical students at a private university in Lima, Peru

INTRODUCTION

There are few studies that examine the factors associated with the different levels of health anxiety in medical students. The objective was to determine the factors associated with the levels of health anxiety in medical students in 2018.

METHODS

An analytical cross-sectional study was carried out with 657 medical students from a private Peruvian university. Participants answered a questionnaire from which information was collected regarding levels of health anxiety (SHAI). For the analysis, linear regression was used to calculate crude and adjusted betas, and their 95% confidence intervals.

RESULTS

The mean health anxiety score was 14 ± 6.7. An association between health anxiety and the year of study is reported, with the second year showing the highest scores. In addition, an association between health anxiety and smoking is highlighted, as there are higher levels in occasional smokers, as well as a weak inverse correlation with age. No association was found with sex, place of birth, or having a first-degree relative that is a doctor or health worker.

CONCLUSIONS

The present study showed that age, year of studies and smoking are associated with health anxiety levels. More studies are required, especially of a longitudinal nature.

Increased Frequency of Health Anxiety in Health Science Students: a Cross Sectional Study in a Greek University

Background:

Ectopic Health Sciences students often experience higher level of stress due to clinical knowledge, and it has been reported that they frequently develop worries and symptoms of illness. These observations had lead to the hypothesis that studying health sciences may increase the risk for developing health anxiety.

Objective:

To investigate the correlation between studying health sciences and health anxiety risk in students of a Greek university.

Methods:

A cross-sectional study was conducted among health science and non-health science students from the University of Thessaly, Greece. The 14 item - Short Health Anxiety Inventory (SHAI) was used to measure students’ health anxiety. Univariable and multivariable logistic regression analyses were used to test the hypothesis.

Results:

The population sample consisted of 562 health science students and 204 agriculture and computer science students. The prevalence of health anxiety (SHAI score >14) was 18.1% (95% CI 15.4%-21.1%) while 8.3% (95% CI 6.4%-10.5%) of the participants suffered from clinical health anxiety (SHAI score >18). Health science students had higher SHAI scores compared to non-health science students. Multivariable analysis revealed an increased risk for health anxiety in health science students (OR: 2.01, 95% CI: 1.02-3.97, p=0.044). Health anxiety was also associated with sex (female) (p<0,008) and the presence of health anxiety in a family member (p<0,001).

Conclusion:

The current study identified studying health sciences as a determinant of health anxiety in students of a Greek university, after considering several confounding factors. This relatively neglected hypothesis should be further examined, preferably in a prospective cohort design.

Factors Associated with Health Anxiety in Medical Students at a Private University in Lima, Peru

INTRODUCTION

There are few studies that examine the factors associated with the different levels of health anxiety in medical students. The objective was to determine the factors associated with the levels of health anxiety in medical students in 2018.

METHODS

An analytical cross-sectional study was carried out with 657 medical students from a private Peruvian university. Participants answered a questionnaire from which information was collected regarding levels of health anxiety (SHAI). For the analysis, linear regression was used to calculate crude and adjusted betas, and their 95% confidence intervals.

RESULTS

The mean health anxiety score was 14±6.7. An association between health anxiety and the year of study is reported, with the second year showing the highest scores. In addition, an association between health anxiety and smoking is highlighted, as there are higher levels in occasional smokers, as well as a weak inverse correlation with age. No association was found with sex, place of birth, or having a first-degree relative that is a doctor or health worker.

CONCLUSIONS

The present study showed that age, year of studies and smoking are associated with health anxiety levels. More studies are required, especially of a longitudinal nature.