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Rask CU, Duholm CS, Poulsen CM, Rimvall MK, Wright KD. Annual Research Review: Health anxiety in children and adolescents-developmental aspects and cross-generational influences. J Child Psychol Psychiatry 2024; 65:413-430. [PMID: 37909255 DOI: 10.1111/jcpp.13912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 11/03/2023]
Abstract
Health anxiety involves excessive worries about one's health along with beliefs one has an illness or may contract a serious disease. Concerning evidence suggests that health anxiety is on the rise in society, possibly further fueled by the COVID-19 pandemic. Recent classification systems acknowledge that impairing health-related worries and beliefs can emerge in early childhood with significant levels of symptoms persisting throughout childhood, and possibly continuous with diagnostic considerations in adulthood. This narrative review summarizes recent research advances in health anxiety in children and adolescents, focusing on various developmental aspects of health anxiety and related concepts in youths. Findings suggest that health anxiety symptoms in young age groups are associated with impairment, distress, and increased healthcare use, as well as substantial comorbidity with mainly other emotional problems and disorders. Furthermore, longitudinal studies suggest that childhood health anxiety can persist across adolescence, perhaps with links to chronic courses in adulthood. The growing literature was further reviewed, thus extending our understanding of early risk factors, including the potential role of exposure to serious illness and transgenerational transmission of health anxiety. Learning more about developmental trajectories will be highly relevant to inform strategies for early detection and prevention. While modified cognitive behavioral therapies in adults are successful in treating health anxiety, specific interventions have not yet been tested in youths. Given substantial overlaps with other psychopathology, it could be important to develop and explore more transdiagnostic and scalable approaches that take advantage of common factors in psychotherapy, while also including a wider perspective on potential familiar maladaptive illness cognitions and behaviors.
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Affiliation(s)
- Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Charlotte Steen Duholm
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Martin Køster Rimvall
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Kristi D Wright
- Department of Psychology, University of Regina, Regina, SK, Canada
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2
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Birkenæs V, Refsum Bakken N, Frei E, Jaholkowski P, Smeland OB, Tesfaye M, Agartz I, Susser E, Bresnahan M, Røysamb E, Nordbø Jørgensen K, Nesvåg R, Havdahl A, Andreassen OA, Elken Sønderby I. Psychometric Properties and Diagnostic Associations of the Short-Form Community Assessment of Psychic Experiences in a Population-Based Sample of 29 021 Adult Men. Schizophr Bull 2023; 49:1229-1238. [PMID: 37262330 PMCID: PMC10483447 DOI: 10.1093/schbul/sbad074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND HYPOTHESIS Around 5%-7% of the adult population are estimated to have lifetime psychotic experiences (PEs), which are associated with psychosis risk. PEs assessed with Community Assessment of Psychic Experiences (CAPE) are associated with psychosis but also non-psychotic disorders, which could be partly explained by CAPE indirectly capturing emotional symptoms. We investigated the psychometric properties of a shorter version, CAPE-9, and whether CAPE-9 scores are associated with lifetime psychotic or non-psychotic mental disorders after controlling for current anxiety and depressive symptoms. DESIGN CAPE-9 questionnaire data were obtained from 29 021 men (42.4 ± 5.6 yrs.) from the Norwegian Mother, Father, and Child Cohort Study. We investigated CAPE-9 reliability and factor structure. Logistic regression was used to test effects of current anxiety and depressive symptoms (SCL-12) on associations between CAPE-9 scores and psychiatric diagnoses. RESULTS CAPE-9 fit a previously reported 3-factor structure and showed good reliability. Twenty-six percent reported at least one lifetime PE. CAPE-9 scores were significantly associated with most psychiatric disorders (schizophrenia, depression, bipolar disorder, substance abuse, anxiety, trauma-related disorders, and ADHD). After controlling for concurrent emotional symptoms, only associations with schizophrenia (OR = 1.29; 95% CI = 1.18-1.38) and trauma-related disorders (OR = 1.09; CI = 1.02-1.15) remained significant. CONCLUSIONS CAPE-9 showed good psychometric properties in this large population-based adult male sample, and PEs were more clearly associated with psychotic disorders after controlling for current emotional symptoms. These results support the use of the short CAPE-9 as a cost-effective tool for informing public health initiatives and advancing our understanding of the dimensionality of psychosis.
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Affiliation(s)
- Viktoria Birkenæs
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nora Refsum Bakken
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Evgeniia Frei
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Piotr Jaholkowski
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Olav B Smeland
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Markos Tesfaye
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakohjemmet Hospital, Oslo, Norway
| | - Ezra Susser
- Mailman School of Public Health, Department of Epidemiology and Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Michaeline Bresnahan
- Mailman School of Public Health, Department of Epidemiology and Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Espen Røysamb
- Faculty of Social Sciences, Department of Psychology, Oslo University Hospital, Oslo, Norway
| | - Kjetil Nordbø Jørgensen
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ragnar Nesvåg
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Alexandra Havdahl
- Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Ida Elken Sønderby
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
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Du X, Witthöft M, Zhang T, Shi C, Ren Z. Interpretation bias in health anxiety: a systematic review and meta-analysis. Psychol Med 2023; 53:34-45. [PMID: 36349699 DOI: 10.1017/s0033291722003427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Interpretation bias (i.e. the selective negative interpretation of ambiguous stimuli) may contribute to the development and maintenance of health anxiety. However, the strength of the empirical evidence for this association remains a topic of debate. This study aimed to estimate the association between health anxiety and interpretation bias and to identify potential moderators of this association. Chinese-language databases (CNKI, VIP, and Wanfang), English-language databases (Web of Science, PubMed, PsycINFO, and Scopus), and German-language databases (Psyndex and PubPsych) were searched for relevant studies. There were 36 articles (39 studies) identified by this search (N = 8984), of which 32 articles (34 studies) were included in the meta-analysis (N = 8602). Results revealed a medium overall effect size (g = 0.67). Statistically equivalent effect sizes were observed for patients diagnosed with clinical health anxiety (g = 0.58) and subclinical health anxiety (g = 0.72). The effect sizes for threat stimuli that were health related (g = 0.68) and not health related (g = 0.63) did not differ significantly. The effect size for studies using an offline paradigm (g = 0.75) was significantly higher than that for studies using an online paradigm (g = 0.50). It is concluded that health anxiety is significantly and robustly associated with interpretation bias. These findings are of central importance for the advancement of models and treatment of health anxiety.
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Affiliation(s)
- Xiayu Du
- Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Tao Zhang
- Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
| | - Congrong Shi
- Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
| | - Zhihong Ren
- Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
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Health anxiety symptoms in pediatric obsessive-compulsive disorder: patient characteristics and effect on treatment outcome. Eur Child Adolesc Psychiatry 2022; 31:1317-1328. [PMID: 33861384 DOI: 10.1007/s00787-021-01774-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
The aim was to explore the potential clinical role of health anxiety (HA) symptoms in children and adolescents diagnosed with obsessive-compulsive disorder (OCD). The study investigated differences in demographic and various clinical variables between young people with OCD, with and without HA symptoms, and the effect of HA symptoms on overall OCD treatment outcome. The study sample comprised 269 children and adolescents with OCD (aged 7-17 years) from the large Nordic Long-term OCD Treatment Study. OCD symptoms and severity were assessed with The Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), which includes one item regarding HA-like obsessions and one item regarding HA-like compulsions that were used to define the HA group. Several other instruments were used to assess comorbidity and other clinical aspects. All participants were treated with 14 weekly protocolled sessions of exposure-based cognitive behavioral therapy (CBT). HA symptoms were present in 31% of participants. Other anxiety symptoms and comorbid anxiety disorders were more prevalent among those with HA symptoms. These patients also presented with significantly more types of OCD symptoms. HA symptoms were reduced following OCD treatment with CBT and having HA symptoms did not affect CBT outcome. Results suggest that pediatric OCD with HA symptoms is characterized by more anxiety symptoms and a more heterogeneous OCD symptom profile. Standardized CBT seems equally effective in treating child and adolescent OCD with or without HA symptoms.Clinical trials registration: Nordic Long-term Obsessive-Compulsive Disorder Treatment Study: www.controlled-trials.com ; ISRCTN66385119.
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Vismara M, Benatti B, Ferrara L, Colombo A, Bosi M, Varinelli A, Pellegrini L, Viganò C, Fineberg NA, Dell'Osso B. A preliminary investigation of Cyberchondria and its correlates in a clinical sample of patients with obsessive-compulsive disorder, anxiety and depressive disorders attending a tertiary psychiatric clinic. Int J Psychiatry Clin Pract 2022; 26:111-122. [PMID: 34032529 DOI: 10.1080/13651501.2021.1927107] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objectives. This cross-sectional study aimed to investigate the frequency and presentation of cyberchondria (CYB) in patients with obsessive-compulsive disorder (OCD), anxiety disorders (ADs), and major depression disorder (MDD).Methods. Seventy-seven patients (OCD:25, ADs:26, MDD:26) referred to a tertiary psychiatry outpatient clinic and 27 healthy controls (HCs) were included. A 'working' definition of CYB was used to measure CYB frequency. CYB severity was measured with the Cyberchondria Severity Scale (CSS).Results. CYB as currently defined was present in just 1.3% of the combined patients' sample. Using a broader definition (omitting the disability criterion), we found a higher distribution (OCD:12%, ADs:19.2%, MDD:15.4%, HCs:3.7%) and greater CYB symptom severity. Patients with OCD (63.3 ± 18.9) and ADs (63.3 ± 25.9) showed a higher CYB severity, compared with HCs (48.4 ± 9.9, p<.05). In the combined patients' sample, a positive correlation was found between the CSS scores and measures of health anxiety or hypochondriasis. Higher CYB symptom severity emerged in patients with a positive family history of psychiatric disorders and in those prescribed benzodiazepines or mood-stabilisers.Conclusion. CYB represents a common transdiagnostic syndrome in patients with OCD, ADs, and MDD with a spectrum of severity and indicates a variable burden of illness, supporting the need for specific clinical considerations and interventions.Key pointsCyberchondria (CYB) represents a common transdiagnostic syndrome in patients with obsessive-compulsive disorder, anxiety, and depressive disorders.CYB's frequency as a syndrome of compulsive online health searches associated with an increased anxiety and distress was reported in 10-20% patients.Health anxiety/hypochondriasis showed a strong correlation with CYB.Patients with a positive family history of psychiatric disorders and those prescribed benzodiazepines or mood-stabilisers showed higher CYB symptom severity.Considering the spread of Internet use for health-related information, additional studies investigating CYB in clinical samples are encouraged.
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Affiliation(s)
- Matteo Vismara
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy.,Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
| | - Beatrice Benatti
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy.,Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
| | - Luca Ferrara
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Anna Colombo
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Monica Bosi
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Alberto Varinelli
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Luca Pellegrini
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK
| | - Caterina Viganò
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Naomi A Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK.,School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Bernardo Dell'Osso
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy.,Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy.,Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, CA, USA.,"Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche", University of Milan, Milan, Italy
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6
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Costa DLDC, de Campos AP, Pereira CADB, Torres AR, Dos Santos AC, Requena G, Ferrão YA, do Rosário MC, Miguel EC, Simpson HB, Shavitt RG, Diniz JB. Latency to treatment seeking in patients with obsessive-compulsive disorder: Results from a large multicenter clinical sample. Psychiatry Res 2022; 312:114567. [PMID: 35490573 DOI: 10.1016/j.psychres.2022.114567] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/10/2022] [Accepted: 04/17/2022] [Indexed: 01/06/2023]
Abstract
This study aimed to identify the factors associated with a delay in treatment-seeking among patients with obsessive-compulsive disorder (OCD), a disabling neuropsychiatric disorder. To achieve this purpose, we conducted a cross-sectional study examining latency to treatment (LTT) and its associated correlates in 863 patients with OCD. We defined LTT as the time lag between the awareness of discomfort and/or impairment caused by symptoms and the beginning of OCD-specific treatment. To determine the socio-demographic and clinical characteristics associated with LTT, we built an interval-censored survival model to simultaneously assess the relationship between all variables, representing the best fit to our data format. The results of our study showed that approximately one-third of OCD patients sought treatment within two years of symptom awareness, one-third between two and nine years, and one-third after ten or more years. Median LTT was 4.0 years (mean = 7.96, SD = 9.54). Longer LTT was associated with older age, early onset of OCD symptoms, presence of contamination/cleaning symptoms and full-time employment. Shorter LTT was associated with the presence of aggression symptoms and comorbidity with hypochondriasis. The results of our study confirm the understanding that LTT in OCD is influenced by several interdependent variables - some of which are modifiable. Strategies for reducing LTT should focus on older patients, who work in a full-time job, and on individuals with early onset of OCD and contamination/cleaning symptoms.
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Affiliation(s)
- Daniel Lucas da Conceição Costa
- Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil; Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (CTOC), Brazil
| | | | - Carlos Alberto de Bragança Pereira
- Institute of Applied Mathematics (INMA), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil; Institute of Mathematics and Statistics, University of Sao Paulo, Sao Paulo, Brazil
| | - Albina R Torres
- Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (CTOC), Brazil; Deparment of Neurology, Psychology and Psychiatry, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Allan Christiano Dos Santos
- Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Guaraci Requena
- Institute of Mathematics and Statistics, University of Sao Paulo, Sao Paulo, Brazil; Institute of Exact Sciences, Federal University of Viçosa, Florestal, Minas Gerais, Brazil
| | - Ygor Arzeno Ferrão
- Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (CTOC), Brazil; Clinical Medical Department, Federal University of Health Sciences of Porto Alegre, Brazil
| | - Maria Conceição do Rosário
- Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (CTOC), Brazil; Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Eurípedes Constantino Miguel
- Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil; Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (CTOC), Brazil
| | - Helen Blair Simpson
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Roseli Gedanke Shavitt
- Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil; Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (CTOC), Brazil
| | - Juliana Belo Diniz
- Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil; Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (CTOC), Brazil
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Vismara M, Varinelli A, Pellegrini L, Enara A, Fineberg NA. New challenges in facing Cyberchondria during the COVID-19 pandemic. Curr Opin Behav Sci 2022; 46:101156. [PMID: 35581995 PMCID: PMC9098916 DOI: 10.1016/j.cobeha.2022.101156] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Cyberchondria (CYB) is characterized
by excessive online searching for medical information and is associated
with increasing levels of distress, anxiety, and interference with daily
activities. As the use of digital devices and the Internet as a source of
everyday information has increased, particularly during the current
coronavirus disease (COVID-19) pandemic, so has CYB, becoming an object
of interest to clinicians and researchers. The present review will
provide an overview of the latest updates in CYB research. Emerging
evidence draws attention to various vulnerability factors for developing
CYB, including personal characteristics such as female gender, younger
age, or a history of mental disorder, as well as engagement in particular
forms of online behavior, such as increased use of social media,
increased acceptance of online information, and information overload.
Additionally, recent studies suggest that CYB may itself act as a
mediating factor for increased COVID-19-related psychological burden.
However, the data are still very sparse. Knowledge gaps include a
universally accepted definition of CYB, severity thresholds to help
differentiate nonpathological online health searches from CYB, as well as
robustly evidence-based interventions.
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Affiliation(s)
- Matteo Vismara
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
- "Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
| | - Alberto Varinelli
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
- "Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
| | - Luca Pellegrini
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, United Kingdom
- Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Arun Enara
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Naomi A Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, United Kingdom
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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Ciułkowicz M, Misiak B, Szcześniak D, Grzebieluch J, Maciaszek J, Rymaszewska J. The Portrait of Cyberchondria-A Cross-Sectional Online Study on Factors Related to Health Anxiety and Cyberchondria in Polish Population during SARS-CoV-2 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074347. [PMID: 35410027 PMCID: PMC8998772 DOI: 10.3390/ijerph19074347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 01/22/2023]
Abstract
The SARS-CoV-2 pandemic has served as a magnifying glass for cyberchondria, while the internet emerged as one of the main sources of medical information and support. The core ambition of this study was to estimate the level of cyberchondria and describe the socio-demographic, clinical and pandemic-related factors affecting its severity amid the SARS-CoV-2 pandemic. A cross-sectional study was performed between 16 May 2020 and 29 December 2020 in Poland within a sample of 538 adult internet users. The online survey tool included a Polish adaptation of the Cyberchondria Severity Scale (CSS-PL) and the Short Health Anxiety Inventory (SHAI), complemented with a set of questions covering sociodemographic, clinical and pandemic-related factors. Participants were clustered according to severity of health anxiety and cyberchondria symptoms. The performed binary logistic regression indicated professional inactivity, having a chronic mental disorder and subjectively limited access to healthcare due to COVID-19 to be key determinants of severe health anxiety and cyberchondria. Cyberchondria might be a remarkable public health issue as large proportion of respondents from the analyzed sample population of internet users met the criteria for severe symptoms. Key determinants of intense cyberchondria corresponded with employment stability, mental resilience and accessibility of healthcare services, which could be greatly challenged amid the pandemic.
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Affiliation(s)
- Marta Ciułkowicz
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland; (B.M.); (D.S.); (J.M.); (J.R.)
- Correspondence:
| | - Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland; (B.M.); (D.S.); (J.M.); (J.R.)
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland; (B.M.); (D.S.); (J.M.); (J.R.)
| | - Jolanta Grzebieluch
- Department of Population Health, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Julian Maciaszek
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland; (B.M.); (D.S.); (J.M.); (J.R.)
| | - Joanna Rymaszewska
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland; (B.M.); (D.S.); (J.M.); (J.R.)
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9
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Boudouda NE, Gana K. Validity Evidence for the Arabic Version of the Multidimensional Inventory of Hypochondriacal Traits (MIHT). CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00687-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Subhas N, Naing KO, Su C, Loo JL, Shahbudin AF, Sivasubramaniam V, Thyagarajan R. Case report on Cotard’s syndrome (CS) in a patient with schizophrenia: a rare case from Malaysia. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00359-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Abstract
Background
Cotard’s syndrome (CS) is a neuropsychiatric condition marked by nihilistic delusional(s). Due to its rarity, misdiagnosis of the syndrome often occurs. The current case study is of a Malaysian woman who was misdiagnosed for several years by professionals due to the presence of hypochondriac symptoms before receiving the correct diagnosis.
Case presentation
In this case presentation, we describe the case of L, a 42-year-old Malaysian lady who was first misdiagnosed with depression. The diagnosis of schizophrenia and CS was confirmed after thorough clinical examination, diagnostic investigations, and deliberation at a departmental forum. The patient improved after receiving electroconvulsive therapy (ECT) along with antipsychotic medications.
Conclusions
This case study highlights the importance of early recognition of CS by professionals as it can save time for both parties when setting up a treatment plan. Essentially, early recognition of CS in schizophrenia is paramount in the process of rapid stabilization through ECT and promotion of patient recovery.
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Mahat-Shamir M, Pitcho-Prelorentzos S, Kagan M, Kestler-Peleg M, Lavenda O. Adjustment Disorder in the Face of COVID-19 Outbreak: The Impact of Death Anxiety, Media Exposure, Fear of Contagion and Hypochondriasis Symptoms. OMEGA-JOURNAL OF DEATH AND DYING 2021:302228211034372. [PMID: 34324401 PMCID: PMC8322959 DOI: 10.1177/00302228211034372] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Based on the theoretical view of Terror Management Theory, the current research
examines whether higher levels of death anxiety symptoms, in the face of the
COVID-19 outbreak, increase the extent to which participants are exposed to
information regarding the spread of the pandemic, as well as the fear of
contagion and symptoms of hypochondriasis, which all in turn increase symptoms
of adjustment disorder. A total number of 302 participants filled out
self-report questionnaires regarding death anxiety, adjustment disorder, the
extent of exposure to information regarding COVID-19, fear of contagion,
hypochondriasis, and demographic information. Structural Equation Modeling
analysis indicated a very good fit of the theoretical model with the data,
confirming the mediation effect of exposure to information, fear of contagion,
and symptoms of hypochondriasis on the association between death anxiety and
adjustment disorder symptoms. Implications for practice are discussed.
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Affiliation(s)
| | | | - Maya Kagan
- School of Social Work, Ariel University, Israel
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12
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Pascual-Vera B, Belloch A. Dysmorphic and illness anxiety-related unwanted intrusive thoughts in individuals with obsessive-compulsive disorder. Clin Psychol Psychother 2021; 29:313-327. [PMID: 34169614 DOI: 10.1002/cpp.2636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/18/2021] [Accepted: 06/15/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVE Unwanted intrusive thoughts (UITs) are considered normal variants of the obsessions found in obsessive-compulsive disorder (OCD). Similarly, intrusive and persistent preoccupations about appearance defects in body dysmorphic disorder (BDD) and images and thoughts about illness in illness anxiety disorder (IAD) are abnormal variants of the thoughts and concerns about appearance and health found in non-clinical individuals. This study examines whether patients with OCD have frequent and distressing UITs with contents related to BDD and IAD, in addition to OCD-related UITs. METHOD Thirty-nine participants with OCD (Mage = 32.45, standard deviation [SD] = 11.57; 63% men) completed the Questionnaire of Unpleasant Intrusive Thoughts (QUIT), designed to assess obsessional, dysmorphic and illness anxiety UITs and their associated functional consequences (emotions, appraisals, and neutralizing or control strategies). RESULTS Up to 71% of the individuals with OCD experienced the three UIT modalities. As expected, OCD-related UITs were the most frequent, although were no differences among the three UIT contents in terms of the disturbance they caused. The OCD intrusions were the most interfering, egodystonic and dysfunctionally appraised, and they instigated more neutralizing behaviours. Nonetheless, all UITs instigate the need to do something to alleviate the discomfort caused by their intrusion and attempts to suppress them. CONCLUSION UITs with different contents not always related to typical obsessive themes are a common experience in patients with OCD. These UITs could have detrimental consequences for the course of the disorder itself, and they should be adequately addressed in both the assessment and treatment of these patients.
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Affiliation(s)
- Belén Pascual-Vera
- Department of Personality Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain.,Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders (I'TOC), University of Valencia, Valencia, Spain
| | - Amparo Belloch
- Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders (I'TOC), University of Valencia, Valencia, Spain
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13
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Eysenbach G, Nazari N, Griffiths MD. Using Fear and Anxiety Related to COVID-19 to Predict Cyberchondria: Cross-sectional Survey Study. J Med Internet Res 2021; 23:e26285. [PMID: 34014833 PMCID: PMC8191728 DOI: 10.2196/26285] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/18/2021] [Accepted: 05/03/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Studies have highlighted that fear and anxiety generated by COVID-19 are important psychological factors that affect all populations. There currently remains a lack of research on specific amplification factors regarding fear and anxiety in the context of the COVID-19 pandemic. Despite established associations between anxiety sensitivity, intolerance of uncertainty, and cyberchondria, empirical data investigating the associations between these three variables, particularly in the context of the COVID-19 pandemic, are currently lacking. Urgent research is needed to better understand the role of repeated media consumption concerning COVID-19 in amplifying fear and anxiety related to COVID-19. OBJECTIVE This study investigated the associations between fear of COVID-19, COVID-19 anxiety, and cyberchondria. METHODS Convenience sampling was used to recruit respondents to participate in an online survey. The survey, which was distributed via social media and academic forums, comprised the Cyberchondria Severity Scale, Fear of COVID-19 Scale, Coronavirus Anxiety Scale, Anxiety Sensitivity Index, and Intolerance of Uncertainty Scale. Multiple mediation analyses were conducted using structural equation modeling. RESULTS A total of 694 respondents (males: n=343, females: n=351) completed the online survey. The results showed that fear and anxiety generated by COVID-19 predicted cyberchondria (fear: β=.39, SE 0.04, P<.001, t=11.16, 95% CI 0.31-0.45; anxiety: β=.25, SE 0.03, P<.001, t=7.67, 95% CI 0.19-0.32). In addition, intolerance of uncertainty and anxiety sensitivity mediated the relationship between fear and anxiety generated by COVID-19 with cyberchondria. In a reciprocal model, the standardized total effects of cyberchondria on fear of COVID-19 (β=.45, SE 0.04, P<.001, t=15.31, 95% CI 0.39-0.51) and COVID-19 anxiety (β=.36, SE 0.03, P<.001, t=11.29, 95% CI 0.30-0.41) were statistically significant, with moderate effect sizes. Compared to males, females obtained significantly higher scores for cyberchondria (t1,692=-2.85, P=.004, Cohen d=0.22), COVID-19 anxiety (t1,692=-3.32, P<.001, Cohen d=0.26), and anxiety sensitivity (t1,692=-3.69, P<.001, Cohen d=0.29). CONCLUSIONS The findings provide a better understanding of the role of COVID-19 in amplifying cyberchondria. Based on these results, cyberchondria must be viewed as a significant public health issue. Importantly, increasing awareness about cyberchondria and online behavior at both the individual and collective levels must be prioritized to enhance preparedness and to reduce the adverse effects of current and future medical crises.
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Affiliation(s)
| | - Nabi Nazari
- Department of Psychology, Faculty of Literature and Human Sciences, Lorestan University, Khorramabad, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Division, Nottingham Trent University, Nottingham, United Kingdom
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14
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Wu X, Nazari N, Griffiths MD. Using Fear and Anxiety Related to COVID-19 to Predict Cyberchondria: Cross-sectional Survey Study. J Med Internet Res 2021. [DOI: doi.org/10.2196/26285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background
Studies have highlighted that fear and anxiety generated by COVID-19 are important psychological factors that affect all populations. There currently remains a lack of research on specific amplification factors regarding fear and anxiety in the context of the COVID-19 pandemic. Despite established associations between anxiety sensitivity, intolerance of uncertainty, and cyberchondria, empirical data investigating the associations between these three variables, particularly in the context of the COVID-19 pandemic, are currently lacking. Urgent research is needed to better understand the role of repeated media consumption concerning COVID-19 in amplifying fear and anxiety related to COVID-19.
Objective
This study investigated the associations between fear of COVID-19, COVID-19 anxiety, and cyberchondria.
Methods
Convenience sampling was used to recruit respondents to participate in an online survey. The survey, which was distributed via social media and academic forums, comprised the Cyberchondria Severity Scale, Fear of COVID-19 Scale, Coronavirus Anxiety Scale, Anxiety Sensitivity Index, and Intolerance of Uncertainty Scale. Multiple mediation analyses were conducted using structural equation modeling.
Results
A total of 694 respondents (males: n=343, females: n=351) completed the online survey. The results showed that fear and anxiety generated by COVID-19 predicted cyberchondria (fear: β=.39, SE 0.04, P<.001, t=11.16, 95% CI 0.31-0.45; anxiety: β=.25, SE 0.03, P<.001, t=7.67, 95% CI 0.19-0.32). In addition, intolerance of uncertainty and anxiety sensitivity mediated the relationship between fear and anxiety generated by COVID-19 with cyberchondria. In a reciprocal model, the standardized total effects of cyberchondria on fear of COVID-19 (β=.45, SE 0.04, P<.001, t=15.31, 95% CI 0.39-0.51) and COVID-19 anxiety (β=.36, SE 0.03, P<.001, t=11.29, 95% CI 0.30-0.41) were statistically significant, with moderate effect sizes. Compared to males, females obtained significantly higher scores for cyberchondria (t1,692=–2.85, P=.004, Cohen d=0.22), COVID-19 anxiety (t1,692=–3.32, P<.001, Cohen d=0.26), and anxiety sensitivity (t1,692=–3.69, P<.001, Cohen d=0.29).
Conclusions
The findings provide a better understanding of the role of COVID-19 in amplifying cyberchondria. Based on these results, cyberchondria must be viewed as a significant public health issue. Importantly, increasing awareness about cyberchondria and online behavior at both the individual and collective levels must be prioritized to enhance preparedness and to reduce the adverse effects of current and future medical crises.
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15
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Varma R, Das S, Singh T. Cyberchondria Amidst COVID-19 Pandemic: Challenges and Management Strategies. Front Psychiatry 2021; 12:618508. [PMID: 33995143 PMCID: PMC8121143 DOI: 10.3389/fpsyt.2021.618508] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 03/08/2021] [Indexed: 12/13/2022] Open
Abstract
The corona-virus disease 2019 (COVID-19), first found in Wuhan, China in December 2019, has posed an inexplicable threat to the global community. After its inception, the virus proliferated rapidly, which led to the cause of millions of deaths, and having a detrimental effect on physical health, social lives, economic uncertainty, and mental health of people. The World Health Organization has reported that there are 111 million confirmed cases of COVID-19 and 2.45 million deaths due to COVID-19 worldwide. Indisputably, the present pandemic has contributed to the extensive psychological and environmental distress together with clinical depression, anxiety and post-traumatic stress disorder (PTSD), domestic violence, and unemployment. Due to the ambiguous nature of the pandemic, educational organizations, and outdoor activities are closed, thus burdening the mental health of younger populations. Children as well as youths are more glued to the Internet for their studies, online gaming, shopping, watching movies, and searching health-related information. Despite the advantages of using the Internet, it has some severe consequences too. Some people are repeatedly searching for physical and mental well-being related information without verifying credible sources, which, in turn, causes distress and anxiety. In such situations, individuals may end up contributing to an illness known as cyberchondria. In this paper, we have tried to highlight the problematic use of Internet for health-related searches and have outlined the management of such illness. We suggest two strategies: firstly, to reduce repeated online searches of health information and, secondly, to manage anxiety-augmenting thoughts that are triggered due to the maladaptive thoughts caused by the abstruse information.
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Affiliation(s)
| | | | - Tushar Singh
- Department of Psychology, Banaras Hindu University, Varanasi, India
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16
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First MB, Gaebel W, Maj M, Stein DJ, Kogan CS, Saunders JB, Poznyak VB, Gureje O, Lewis-Fernández R, Maercker A, Brewin CR, Cloitre M, Claudino A, Pike KM, Baird G, Skuse D, Krueger RB, Briken P, Burke JD, Lochman JE, Evans SC, Woods DW, Reed GM. An organization- and category-level comparison of diagnostic requirements for mental disorders in ICD-11 and DSM-5. World Psychiatry 2021; 20:34-51. [PMID: 33432742 PMCID: PMC7801846 DOI: 10.1002/wps.20825] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In 2013, the American Psychiatric Association (APA) published the 5th edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In 2019, the World Health Assembly approved the 11th revision of the International Classification of Diseases (ICD-11). It has often been suggested that the field would benefit from a single, unified classification of mental disorders, although the priorities and constituencies of the two sponsoring organizations are quite different. During the development of the ICD-11 and DSM-5, the World Health Organization (WHO) and the APA made efforts toward harmonizing the two systems, including the appointment of an ICD-DSM Harmonization Group. This paper evaluates the success of these harmonization efforts and provides a guide for practitioners, researchers and policy makers describing the differences between the two systems at both the organizational and the disorder level. The organization of the two classifications of mental disorders is substantially similar. There are nineteen ICD-11 disorder categories that do not appear in DSM-5, and seven DSM-5 disorder categories that do not appear in the ICD-11. We compared the Essential Features section of the ICD-11 Clinical Descriptions and Diagnostic Guidelines (CDDG) with the DSM-5 criteria sets for 103 diagnostic entities that appear in both systems. We rated 20 disorders (19.4%) as having major differences, 42 disorders (40.8%) as having minor definitional differences, 10 disorders (9.7%) as having minor differences due to greater degree of specification in DSM-5, and 31 disorders (30.1%) as essentially identical. Detailed descriptions of the major differences and some of the most important minor differences, with their rationale and related evidence, are provided. The ICD and DSM are now closer than at any time since the ICD-8 and DSM-II. Differences are largely based on the differing priorities and uses of the two diagnostic systems and on differing interpretations of the evidence. Substantively divergent approaches allow for empirical comparisons of validity and utility and can contribute to advances in the field.
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Affiliation(s)
- Michael B First
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Dan J Stein
- Department of Psychiatry, University of Cape Town and South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | - Cary S Kogan
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - John B Saunders
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, QLD, Australia
| | - Vladimir B Poznyak
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Roberto Lewis-Fernández
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Andreas Maercker
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Chris R Brewin
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Marylene Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, USA
| | - Angelica Claudino
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Kathleen M Pike
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Gillian Baird
- Newcomen Centre, Evelina Children's Hospital, Guys & St. Thomas NHS Foundation Trust, London, UK
| | - David Skuse
- Brain and Behaviour Science Unit, Institute of Child Health, University College London, London, UK
| | - Richard B Krueger
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jeffrey D Burke
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - John E Lochman
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | | | - Douglas W Woods
- Offiice of the Provost and Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
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17
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Shen Z, Yu L, Zhao Z, Jin K, Pan F, Hu S, Li S, Xu Y, Xu D, Huang M. Gray Matter Volume and Functional Connectivity in Hypochondriasis: A Magnetic Resonance Imaging and Support Vector Machine Analysis. Front Hum Neurosci 2020; 14:596157. [PMID: 33343319 PMCID: PMC7738430 DOI: 10.3389/fnhum.2020.596157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/23/2020] [Indexed: 12/19/2022] Open
Abstract
Objective: Patients with hypochondriasis hold unexplainable beliefs and a fear of having a lethal disease, with poor compliances and treatment response to psychotropic drugs. Although several studies have demonstrated that patients with hypochondriasis demonstrate abnormalities in brain structure and function, gray matter volume (GMV) and functional connectivity (FC) in hypochondriasis still remain unclear. Methods: The present study collected T1-weighted and resting-state functional magnetic resonance images from 21 hypochondriasis patients and 22 well-matched healthy controls (HCs). We first analyzed the difference in the GMV between the two groups. We then used the regions showing a difference in GMV between two groups as seeds to perform functional connectivity (FC) analysis. Finally, a support vector machine (SVM) was applied to the imaging data to distinguish hypochondriasis patients from HCs. Results: Compared with the HCs, the hypochondriasis group showed decreased GMV in the left precuneus, and increased GMV in the left medial frontal gyrus. FC analyses revealed decreased FC between the left medial frontal gyrus and cuneus, and between the left precuneus and cuneus. A combination of both GMV and FC in the left precuneus, medial frontal gyrus, and cuneus was able to discriminate the hypochondriasis patients from HCs with a sensitivity of 0.98, specificity of 0.93, and accuracy of 0.95. Conclusion: Our study suggests that smaller left precuneus volumes and decreased FC between the left precuneus and cuneus seem to play an important role of hypochondriasis. Future studies are needed to confirm whether this finding is generalizable to patients with hypochondriasis.
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Affiliation(s)
- Zhe Shen
- Department of Psychiatry, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Liang Yu
- Department of Anesthesiology and Pain, The Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhiyong Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Kangyu Jin
- Department of Psychiatry, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Fen Pan
- Department of Psychiatry, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Shangda Li
- Department of Psychiatry, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Yi Xu
- Department of Psychiatry, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Dongrong Xu
- Columbia University and New York State Psychiatric Institute, Riverside Drive, New York, NY, United States
| | - Manli Huang
- Department of Psychiatry, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
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18
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Seyed Hashemi SG, Hosseinnezhad S, Dini S, Griffiths MD, Lin CY, Pakpour AH. The mediating effect of the cyberchondria and anxiety sensitivity in the association between problematic internet use, metacognition beliefs, and fear of COVID-19 among Iranian online population. Heliyon 2020; 6:e05135. [PMID: 33072911 PMCID: PMC7547399 DOI: 10.1016/j.heliyon.2020.e05135] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 09/20/2020] [Accepted: 09/28/2020] [Indexed: 12/29/2022] Open
Abstract
With the rapid growth of the novel coronavirus disease 2019 (COVID-19), individuals may try to find related medical information using the internet to overcome their fears. Under such circumstances, individuals with the features of cyberchondria, anxiety sensitivity, and metacognitive beliefs in negative thoughts may suffer more fears than those without these features. Therefore, the present study proposed a model to understand the associations between problematic internet use (PIU), cyberchondria, anxiety sensitivity, metacognition beliefs, and fear of COVID-19. Utilizing a cross-sectional online survey, 651 Iranians completed the following psychometric scales: Metacognition Questionnaire-30 (MCQ-30), Anxiety Sensitivity Questionnaire (ASI), Cyberchondria Severity Scale-Short Form (CSS-12), Fear of COVID-19 Scale (FCV-19S), and Generalized Problematic Internet Use Scale (GPIUS). Structural equation modeling (SEM) was used to assess the proposed model via several fit indices. The indices include Tucker-Lewis index (TLI), comparative fit index (CFI), standardized root mean square residual (SRMR), and root mean square error of approximation (RMSEA). The fit indices (CFI = 0.948, TLI = 0.938, RMSEA = 0.053, and SRMR = 0.001) indicated the good fit between the data and the proposed model. Moreover, fear of COVID-19 was significantly and directly predicted by cyberchondria (β = 0.479, p < .001) and anxiety sensitivity (β = 0.286, p < .001). The relationship between PIU and cyberchondria with fear of COVID-19 was mediated significantly by anxiety sensitivity and metacognitive beliefs. Because fear of COVID-19 was found to be significantly associated with cyberchondria and anxiety sensitivity, healthcare providers may want to provide additional support for those with cyberchondria and anxiety sensitivity tendencies.
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Affiliation(s)
- Seyed Ghasem Seyed Hashemi
- Department of Psychology, Faculty of Psychology and Educational Sciences, Azarbaijan Shahid Madani University, Tabriz, Iran
| | | | - Solmaz Dini
- Department of Psychology, Faculty of Psychology and Educational Sciences, Bonab Branch, Payame Noor University, Bonab, Iran
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Amir H. Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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19
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Kogan CS, Stein DJ, Rebello TJ, Keeley JW, Chan KJ, Fineberg NA, Fontenelle LF, Grant JE, Matsunaga H, Simpson HB, Thomsen PH, van den Heuvel OA, Veale D, Grenier J, Kulygina M, Matsumoto C, Domínguez-Martínez T, Stona AC, Wang Z, Reed GM. Accuracy of diagnostic judgments using ICD-11 vs. ICD-10 diagnostic guidelines for obsessive-compulsive and related disorders. J Affect Disord 2020; 273:328-340. [PMID: 32560926 DOI: 10.1016/j.jad.2020.03.103] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/28/2020] [Accepted: 03/28/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND We report results of an internet-based field study evaluating the diagnostic guidelines for the newly introduced ICD-11 grouping of obsessive-compulsive and related disorders (OCRD). We examined accuracy of clinicians' diagnostic judgments applying draft ICD-11 as compared to the ICD-10 diagnostic guidelines to standardized case vignettes. METHODS 1,717 mental health professionals who are members of the World Health Organization's Global Clinical Practice Network completed the study in Chinese, English, French, Japanese, Russian or Spanish. Participants were randomly assigned to apply ICD-11 or ICD-10 guidelines to one of nine pairs of case vignettes. RESULTS Participants using ICD-11 outperformed those using ICD-10 in correctly identifying newly introduced OCRD, although results were mixed for differentiating OCRD from disorders in other groupings largely due to clinicians having difficulty differentiating challenging presentations of OCD. Clinicians had difficulty applying a three-level insight qualifier, although the 'poor to absent' level assisted with differentiating OCRD from psychotic disorders. Brief training on the rationale for an OCRD grouping did not improve diagnostic accuracy suggesting sufficient detail of the proposed guidelines. LIMITATIONS Standardized case vignettes were manipulated to include specific characteristics; the degree of accuracy of clinicians' diagnostic judgments about these vignettes may not generalize to application in routine clinical practice. CONCLUSIONS Overall, use of the ICD-11 guidelines resulted in more accurate diagnosis of case vignettes compared to the ICD-10 guidelines, particularly in differentiating OCRD presentations from one another. Specific areas in which the ICD-11 guidelines did not perform as intended provided the basis for further revisions to the guidelines.
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Affiliation(s)
- Cary S Kogan
- School of Psychology, Faculty of Social Sciences, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON K1N 6N5, Canada.
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town Dept of Psychiatry & Neuroscience Institute, Groote Schuur Hospital, J-Block, Anzio Road, Observatory 7925, Cape Town, South Africa.
| | - Tahilia J Rebello
- Global Mental Health Program, Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, Mailman School of Public Health, 722 West 168th, Floor R2, R-233, New York, NY 10032, USA.
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Box 842018, Richmond, VA 23284, USA.
| | - K Jacky Chan
- School of Psychology, Faculty of Social Sciences, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON K1N 6N5, Canada.
| | - Naomi A Fineberg
- Highly Specialized Obsessive Compulsive and Related Disorders Service, Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, UK; Postgraduate Medical School, University of Hertfordshire, Hatfield, UK; University of Cambridge School of Clinical Medicine, Cambridge, UK.
| | - Leonardo F Fontenelle
- Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; "D'Or' Institute for Research and Education, Rio de Janeiro, RJ, Brazil; School of Psychological Sciences, Monash University, Melbourne, Australia.
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
| | - Hisato Matsunaga
- Department of Neuropsychiatry, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya Hyogo, Japan.
| | - H Blair Simpson
- College of Physicians and Surgeons, Columbia University, New York, NY, USA; Anxiety Disorders Clinic and the Center for OCD and Related Disorders, New York State Psychiatric Institute, New York, NY, USA.
| | - Per Hove Thomsen
- Department for Child and Adolescent Psychiatry, Aarhus University Hospital, Skejby, Aarhus, Denmark.
| | - Odile A van den Heuvel
- Amsterdam University Medical Centers, Vrije Universiteit, Department of Psychiatry and Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, the Netherlands.
| | - David Veale
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Center for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, London, UK.
| | - Jean Grenier
- Institut du Savoir Montfort - Hôpital Montfort and Université d'Ottawa, Ottawa, Ontario, Canada.
| | - Mayya Kulygina
- Alekseev Mental Health Clinic, No. 1, Education Centre, Moscow, Russian Federation.
| | - Chihiro Matsumoto
- National Study Coordinator for ICD-11 Field Studies, ICD-11 Committee, Japanese Society of Psychiatry and Neurology, Hongo-Yumicho Building, 2-38-4, Hongo, Bunkyo-ku, Tokyo 113-0033. Japan.
| | - Tecelli Domínguez-Martínez
- Center for Research on Global Mental Health, Direction of Epidemiology and Psychosocial Research, National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico.
| | - Anne-Claire Stona
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore.
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, PR China.
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA; Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.
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20
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Vismara M, Caricasole V, Starcevic V, Cinosi E, Dell'Osso B, Martinotti G, Fineberg NA. Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence. Compr Psychiatry 2020; 99:152167. [PMID: 32146315 DOI: 10.1016/j.comppsych.2020.152167] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/06/2020] [Accepted: 02/10/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cyberchondria (CYB) has been described relatively recently as a behaviour characterized by excessive online searching for medical information that is associated with increasing levels of health anxiety. Although CYB has received some attention from researchers, there is no consensus about many of its aspects. AIMS We describe one of the first reported cases of a treatment-seeking patient with CYB. We review the published literature on the definition of CYB, its assessment, epidemiology, cost and burden, psychological models and mechanisms associated with CYB, relationships between CYB and mental disorders and prevention and treatment strategies. METHODS Systematic review of all peer-reviewed papers published within the PubMed, PsycINFO, and Cochrane Library databases. RESULTS 61 articles were selected. Nearly all the studies were descriptive and cross-sectional recruiting sample mainly from the general/university student population and collecting self-report data via online surveys. Data on epidemiology, clinical features, course, comorbidity and therapeutic interventions were scarce. CYB showed a self-reported association with health anxiety, hypochondriasis and obsessive-compulsive disorder (OCD) as well as other forms of problematic usage of the internet (PUI) The psychological mechanisms associated with CYB include low self-esteem, anxiety sensitivity, intolerance of uncertainty, pain catastrophizing and certain meta-cognitive beliefs. CONCLUSION A working definition of CYB includes excessive online health searches that are compulsive and may serve the purpose of seeking reassurance, whilst leading to a worsening of anxiety or distress and further negative consequences. CYB represents a clinically relevant transdiagnostic compulsive behavioural syndrome, closely related to PUI and usually presenting in association with health anxiety, hypochondriasis and/or OCD. CYB is clearly in need of further study and we identify key areas for future research.
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Affiliation(s)
- Matteo Vismara
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy.
| | - Valentina Caricasole
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
| | - Vladan Starcevic
- Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, Discipline of Psychiatry, University of Sydney, Sydney, Australia; Department of Psychiatry, Nepean Hospital, Penrith, NSW, Australia
| | - Eduardo Cinosi
- Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire, UK; University of Hertfordshire, Hatfield, UK
| | - Bernardo Dell'Osso
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, CA, USA; "Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
| | - Giovanni Martinotti
- University G. D'Annunzio University, Department of Neuroscience, Imaging, Clinical Sciences, Chieti-Pescara, Italy
| | - Naomi A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire, UK; University of Hertfordshire, Hatfield, UK
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21
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Gehrt TB, Frostholm L, Obermann ML, Berntsen D. Autobiographical Memory and Episodic Future Thinking in Severe Health Anxiety: A Comparison with Obsessive–Compulsive Disorder. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10058-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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22
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Eichenberg C, Schott M. Use of Web-Based Health Services in Individuals With and Without Symptoms of Hypochondria: Survey Study. J Med Internet Res 2019; 21:e10980. [PMID: 31199311 PMCID: PMC6592511 DOI: 10.2196/10980] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 09/30/2018] [Accepted: 04/27/2019] [Indexed: 01/28/2023] Open
Abstract
Background An increasing number of people consult physicians because of distressing information found online. Cyberchondria refers to the phenomenon of health anxiety because of online health information. Objective This study aimed to examine online health research of individuals with and without symptoms of hypochondria and their impact on health anxiety as well as behavior. Methods An online survey was conducted. Demographic data, health-related internet use, and general health behavior were assessed. The illness attitude scale was used to record symptoms of hypochondria. Results The final sample consisted of N=471 participants. More than 40% (188/471) of participants showed at least some symptoms of hypochondria. Participants with symptoms of hypochondria used the internet more frequently for health-related purposes and also frequented more online services than individuals without symptoms. Most online health services were rated as more reliable by individuals with symptoms of hypochondria. Changes to behavior such as doctor hopping or ordering nonprescribed medicine online were considered more likely by individuals with symptoms of hypochondria. Conclusions Results show that individuals with symptoms of hypochondria do not turn to online research as a result of lacking alternatives but rather consult health services on- as well as offline.
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Affiliation(s)
| | - Markus Schott
- Sigmund Freud Privat Universität Wien, Vienna, Austria
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23
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Lavenda O, Mahat‐Shamir M, Lorenz L, Hamama‐Raz Y, Greenblatt‐Kimron L, Pitcho‐Prelorentzos S, Ring L, Bar‐Shua E, Ben‐Ezra M. Revalidation of Adjustment Disorder–New Module‐4 screening of adjustment disorder in a non‐clinical sample: Psychometric reevaluation and correlates with other
ICD‐11
mental disorders. Psych J 2019; 8:378-385. [DOI: 10.1002/pchj.286] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 02/08/2019] [Accepted: 02/18/2019] [Indexed: 01/31/2023]
Affiliation(s)
| | | | - Louisa Lorenz
- Department of PsychologyUniversity of Zurich Zurich Switzerland
- Klinik im HaselStationäre Therapie Gontenschwil Switzerland
| | | | | | | | - Lia Ring
- School of Social WorkAriel University Ariel Israel
| | - Eti Bar‐Shua
- School of Social WorkAriel University Ariel Israel
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24
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López-Solà C, Bui M, Hopper JL, Fontenelle LF, Davey CG, Pantelis C, Alonso P, van den Heuvel OA, Harrison BJ. Predictors and consequences of health anxiety symptoms: a novel twin modeling study. Acta Psychiatr Scand 2018; 137:241-251. [PMID: 29336012 DOI: 10.1111/acps.12850] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The question of how to best conceptualize health anxiety (HA) from a diagnostic and etiological perspective remains debated. The aim was to examine the relationship between HA and the symptoms of anxiety and obsessive-compulsive-related disorders in a normative twin population. METHOD Four hundred and ninety-six monozygotic adult twin pairs from the Australian Twin Registry participated in the study (age, 34.4 ± 7.72 years; 59% females). Validated scales were used to assess each domain. We applied a twin regression methodology-ICE FALCON-to determine whether there was evidence consistent with 'causal' relationships between HA and other symptoms by fitting and comparing model estimates. RESULTS Estimates were consistent with higher levels of obsessing ('unwanted thoughts') (P = 0.008), social anxiety (P = 0.03), and body dysmorphic symptoms (P = 0.008) causing higher levels of HA symptoms, and with higher levels of HA symptoms causing higher levels of physical/somatic anxiety symptoms (P = 0.001). CONCLUSION Obsessional thoughts, body dysmorphic concerns, and social anxiety symptoms may have a causal influence on HA. To report physical/somatic anxiety appears to be a consequence of the underlying presence of HA-related fears. Should our results be confirmed by longitudinal studies, the evaluation and treatment of HA may benefit from the consideration of these identified risk factors.
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Affiliation(s)
- C López-Solà
- Adult Mental Health Department, Parc Taulí University Hospital, Universitat Autònoma de Barcelona, Sabadell, Spain.,Carlos III Health Institute, CIBERSAM (Centro de Investigación en Red de Salud Mental), Barcelona, Spain
| | - M Bui
- Centre for Epidemiology and Biostatistics, Melbourne School of Population Health, The University of Melbourne, Melbourne, Vic, Australia
| | - J L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population Health, The University of Melbourne, Melbourne, Vic, Australia.,Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnamgu, Seoul, South Korea
| | - L F Fontenelle
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, South Korea.,Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil.,Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Vic, Australia
| | - C G Davey
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Vic, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Vic, Australia.,Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Vic, Australia
| | - C Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Vic, Australia
| | - P Alonso
- Carlos III Health Institute, CIBERSAM (Centro de Investigación en Red de Salud Mental), Barcelona, Spain.,Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - O A van den Heuvel
- Department of Anatomy and Neurosciences, VU university medical center (VUmc), Amsterdam, The Netherlands.,Department of Psychiatry, VUmc, Amsterdam, The Netherlands.,Neuroscience Campus Amsterdam, VU/VUmc, Amsterdam, The Netherlands.,The OCD team, Haukeland University Hospital, Bergen, Norway
| | - B J Harrison
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Vic, Australia
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25
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Abstract
SUMMARYHealth anxiety is an important new diagnosis that is increasing in frequency because of changing attitudes towards health, particularly excessive use of health information on the internet (cyberchondria). People with abnormal health anxiety become over-diligent monitors of their health, misinterpret most somatic sensations as evidence of disease, consult medical professionals unnecessarily and frequently, and are often over-investigated. Relatively few patients with health anxiety present to psychiatrists; most are seen in primary and secondary medical care. This paper reviews the diagnosis and presenting features of health anxiety, its identification in practice and its treatment. A range of simple psychological treatments have been shown to have long-lasting benefit for the disorder but are greatly under-used.LEARNING OBJECTIVES•To be able to identify abnormal health anxiety with the aid of probe questions•To respond to people whom you have identified with excessive health anxiety in a way that facilitates its treatment•To learn a few simple techniques derived from cognitive–behavioural therapy that can lead to long-term benefitDECLARATION OF INTERESTNone.
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26
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Hypochondriasis Differs From Panic Disorder and Social Phobia: Specific Processes Identified Within Patient Groups. J Nerv Ment Dis 2017; 205:227-233. [PMID: 27805984 DOI: 10.1097/nmd.0000000000000613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Studies of the comorbidity of hypochondriasis have indicated high rates of cooccurrence with other anxiety disorders. In this study, the contrast among hypochondriasis, panic disorder, and social phobia was investigated using specific processes drawing on cognitive-perceptual models of hypochondriasis. Affective, behavioral, cognitive, and perceptual processes specific to hypochondriasis were assessed with 130 diagnosed participants based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria (66 with hypochondriasis, 32 with panic disorder, and 32 with social phobia). All processes specific to hypochondriasis were more intense for patients with hypochondriasis in contrast to those with panic disorder or social phobia (0.61 < d < 2.67). No differences were found between those with hypochondriasis with comorbid disorders and those without comorbid disorders. Perceptual processes were shown to best discriminate between patients with hypochondriasis and those with panic disorder.
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27
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Villadsen A, Thorgaard MV, Hybel KA, Jensen JS, Thomsen PH, Rask CU. Health anxiety symptoms in children and adolescents diagnosed with OCD. Eur Child Adolesc Psychiatry 2017; 26:241-251. [PMID: 27357512 DOI: 10.1007/s00787-016-0884-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/21/2016] [Indexed: 11/30/2022]
Abstract
Health anxiety (HA) is an overlooked area in paediatric research. Little is known about the occurrence of HA symptoms in a child and adolescent psychiatric setting, and there are no age-appropriate diagnostic criteria and only limited number of assessment tools. It is therefore likely that HA is seen as part of obsessive-compulsive disorder (OCD) due to construct overlap and the diagnostic uncertainty of HA in this age group. In the present study, the extent of HA symptoms was investigated in 94 children and adolescents with a primary ICD-10 diagnosis of OCD. Self-reported HA symptoms were assessed using the Childhood Illness Attitude Scales. Clinician-rated OCD symptoms and severity were measured using the Children's Yale Brown Obsessive Compulsive Scale. Information on socio-demographics was obtained from the child's/adolescent's medical record. The distribution of HA symptoms resembled a normal curve shifted to the right compared with a normal population of Danish children, and 30 % presented with high HA symptoms. Chi-squared tests were used to examine the proportion of children and adolescents with high HA symptoms in relation to various clinical characteristics. Clinician-rated illness worries and comorbid anxiety disorder were associated with high self-reported HA symptoms. The results contribute to the understanding of how HA and OCD overlap conceptually in young patients and bring attention to the need for improved recognition of OCD patients dominated by illness worries. Further research in the description of childhood HA is important in order to understand whether HA is a distinct disorder early in life.
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Affiliation(s)
- Anna Villadsen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark. .,Centre for Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus C, Denmark.
| | - Mette V Thorgaard
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark
| | - Katja A Hybel
- Centre for Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus C, Denmark
| | - Jens Søndergaard Jensen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark
| | - Per H Thomsen
- Centre for Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus C, Denmark
| | - Charlotte U Rask
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark.,Centre for Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus C, Denmark
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28
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Kogan CS, Stein DJ, Maj M, First MB, Emmelkamp PMG, Reed GM. The Classification of Anxiety and Fear-Related Disorders in the ICD-11. Depress Anxiety 2016; 33:1141-1154. [PMID: 27411108 DOI: 10.1002/da.22530] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 01/21/2023] Open
Abstract
Anxiety disorders are highly prevalent worldwide and engender substantial economic costs and disability. The World Health Organization is currently developing the Eleventh Revision of the International Classification of Diseases and Related Health Problems (ICD-11), which represents the first opportunity to improve the validity, clinical utility, and global applicability of the classification in more than 25 years. This article describes changes in the organization and diagnostic guidelines for anxiety and fear-related disorders proposed by the ICD-11 Working Group on the Classification of Mood and Anxiety Disorders and the rationale and evidence base for the proposals. In ICD-11, anxiety and fear-related disorders that manifest across the lifespan are brought together under a new grouping, and are partly distinguished by their focus of apprehension. The focus of apprehension is the stimulus or situation that triggers the fear or anxiety and may be highly specific as in specific phobia or relate to a broader class of situations as in social anxiety disorder. The guidelines also clarify the relationship between panic disorder and agoraphobia and a qualifier is provided for panic attacks in the context of other disorders. A standardized format emphasizing essential features of anxiety disorders is intended to improve clinical utility. Guidelines will be further refined based on findings from two types of field studies: those using a case-controlled vignette methodology disseminated via the Internet to practitioners worldwide (http://gcp.network) and clinic-based field trials implemented globally at participating field study centers.
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Affiliation(s)
- Cary S Kogan
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Dan J Stein
- Department of Psychiatry, University of Cape Town Groote Schuur Hospital, Cape Town, South Africa
| | - Mario Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - Michael B First
- Department of Psychiatry, Columbia University New York State Psychiatric Institute, New York, New York
| | - Paul M G Emmelkamp
- Department of Clinical Psychology, University of Amsterdam and The Netherlands Institute for Advanced Study, Amsterdam, The Netherlands
| | - Geoffrey M Reed
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.,Faculty of Psychology, National Autonomous University of Mexico, Mexico City, Mexico
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29
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Leonidou C, Panayiotou G, Bati A, Karekla M. Coping with psychosomatic symptoms: The buffering role of psychological flexibility and impact on quality of life. J Health Psychol 2016; 24:175-187. [DOI: 10.1177/1359105316666657] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Individual differences in avoidant coping were hypothesized to exacerbate quality of life impairment associated with somatization and illness anxiety symptoms; psychological flexibility was expected to moderate this impairment. Individuals from a random community sample ( N = 298; 182 females), who met screening criteria for somatization and illness anxiety, reported lower quality of life and psychological flexibility and greater avoidant coping compared to controls. Psychological flexibility significantly moderated the impact of somatization and illness anxiety on quality of life domains. Findings suggest that decreasing avoidant coping through therapy may be promising in mitigating the negative impact of these symptom categories.
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30
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The clinical inadequacy of the DSM-5 classification of somatic symptom and related disorders: an alternative trans-diagnostic model. CNS Spectr 2016; 21:310-7. [PMID: 26707822 DOI: 10.1017/s1092852915000760] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The Diagnostic and Statistical of Mental Disorders, Fifth Edition (DSM-5) somatic symptom and related disorders chapter has a limited clinical utility. In addition to the problems that the single diagnostic rubrics and the deletion of the diagnosis of hypochondriasis entail, there are 2 major ambiguities: (1) the use of the term "somatic symptoms" reflects an ill-defined concept of somatization and (2) abnormal illness behavior is included in all diagnostic rubrics, but it is never conceptually defined. In the present review of the literature, we will attempt to approach the clinical issue from a different angle, by introducing the trans-diagnostic viewpoint of illness behavior and propose an alternative clinimetric classification system, based on the Diagnostic Criteria for Psychosomatic Research.
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31
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Stein DJ, Kogan CS, Atmaca M, Fineberg NA, Fontenelle LF, Grant JE, Matsunaga H, Reddy YCJ, Simpson HB, Thomsen PH, van den Heuvel OA, Veale D, Woods DW, Reed GM. The classification of Obsessive-Compulsive and Related Disorders in the ICD-11. J Affect Disord 2016; 190:663-674. [PMID: 26590514 DOI: 10.1016/j.jad.2015.10.061] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/24/2015] [Accepted: 10/23/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND To present the rationale for the new Obsessive-Compulsive and Related Disorders (OCRD) grouping in the Mental and Behavioural Disorders chapter of the Eleventh Revision of the World Health Organization's International Classification of Diseases and Related Health Problems (ICD-11), including the conceptualization and essential features of disorders in this grouping. METHODS Review of the recommendations of the ICD-11 Working Group on the Classification for OCRD. These sought to maximize clinical utility, global applicability, and scientific validity. RESULTS The rationale for the grouping is based on common clinical features of included disorders including repetitive unwanted thoughts and associated behaviours, and is supported by emerging evidence from imaging, neurochemical, and genetic studies. The proposed grouping includes obsessive-compulsive disorder, body dysmorphic disorder, hypochondriasis, olfactory reference disorder, and hoarding disorder. Body-focused repetitive behaviour disorders, including trichotillomania and excoriation disorder are also included. Tourette disorder, a neurological disorder in ICD-11, and personality disorder with anankastic features, a personality disorder in ICD-11, are recommended for cross-referencing. LIMITATIONS Alternative nosological conceptualizations have been described in the literature and have some merit and empirical basis. Further work is needed to determine whether the proposed ICD-11 OCRD grouping and diagnostic guidelines are mostly likely to achieve the goals of maximizing clinical utility and global applicability. CONCLUSION It is anticipated that creation of an OCRD grouping will contribute to accurate identification and appropriate treatment of affected patients as well as research efforts aimed at improving our understanding of the prevalence, assessment, and management of its constituent disorders.
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Affiliation(s)
- D J Stein
- Department of Psychiatry and MRC Unit on Anxiety and Stress Disorders, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa.
| | - C S Kogan
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - M Atmaca
- Department of Psychiatry, School of Medicine, Firat (Euphrates) University, Elazig, Turkey
| | - N A Fineberg
- Highly Specialized Obsessive Compulsive and Related Disorders Service, Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, UK; Postgraduate Medical School, University of Hertfordshire, Hatfield, UK; University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - L F Fontenelle
- Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; "D'Or' Institute for Research and Education, Rio de Janeiro, RJ, Brazil; School of Psychological Sciences, Monash University, Melbourne, Australia
| | - J E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - H Matsunaga
- Department of Neuropsychiatry, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya Hyogo, Japan
| | - Y C J Reddy
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - H B Simpson
- College of Physicians and Surgeons, Columbia University Medical College, New York, NY, USA; Anxiety Disorders Clinic and the Center for OCD and Related Disorders, New York State Psychiatric Institute, New York, NY, USA
| | - P H Thomsen
- Centre for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Aarhus, Denmark
| | - O A van den Heuvel
- Department of Psychiatry, VU University Medical Center (VUmc), Amsterdam, The Netherlands; Department of Anatomy & Neurosciences, VUmc, Amsterdam, The Netherlands
| | - D Veale
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Center for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, London, UK
| | - D W Woods
- Psychology Department, Texas A&M University, College Station, TX, USA
| | - G M Reed
- Department of Psychology, National Autonomous University of Mexico (UNAM), Mexico, DF, Mexico; National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico, DF, Mexico; Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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32
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Abstract
PURPOSE OF REVIEW As a part of the its current revision of the International Classification of Diseases (ICD), the WHO is proposing major changes to the somatoform section of the chapter on Mental and Behavioral Disorders. This article reviews the basis for these changes and presents the highlights of the new category being proposed. RECENT FINDINGS As currently classified in ICD-10, somatoform disorders have major problems that limit their clinical utility. Among these are the negative criterion specifications for the diagnosis of the disorders, the rarity of the prototype categories, and the imprecise boundaries between them. To respond to these problems, a new category of Bodily Distress Disorder (BDD) is proposed to replace the current categories. The proposed category is defined by a simplified set of criterion specifications that are based on the presence of positive psycho-behavioral features. SUMMARY The new category, still in proposal stage, offers the prospect of responding to the need for a reliable diagnosis of clinically significant somatic preoccupations that are common in the community as well as in routine clinical practice. It is expected that improved diagnosis should aid the correct identification of these conditions and enhance the ability of clinicians to provide effective treatment.
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33
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Abstract
OBJECTIVE This article presents the conceptual and diagnostic conundrums surrounding hypochondriasis and reviews current treatment options for this disorder. CONCLUSIONS The removal of hypochondriasis from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and its replacement with two new diagnostic entities have been controversial. It appears that the Eleventh Revision of the International Classification of Diseases will take a more cautious approach and emphasise the links between hypochondriasis, obsessive-compulsive disorder and other anxiety disorders. The cornerstone of any treatment approach to hypochondriasis is establishing a good therapeutic relationship with the patient. Psychological treatments, especially cognitive-behavioural therapy, have been more useful than pharmacotherapy, but there is much room for improving treatment outcomes.
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Affiliation(s)
- Vladan Starcevic
- Associate Professor, University of Sydney, Sydney Medical School - Nepean, Discipline of Psychiatry, Penrith, NSW, Australia
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