Severe Illness Anxiety Treated by Integrating Inpatient Psychotherapy With Medical Care and Minimizing Reassurance

New-Onset Illness Anxiety Disorder After Helicobacter Pylori Infection: A Case Report

In this study, we present a case of new-onset illness anxiety disorder (IAD) in a 21-year-old female patient after Heliobacter pylori infection. The patient experienced a distressing preoccupation with having or acquiring a serious illness with mild somatic symptoms for more than six months. IAD adversely affected our patient's life and made her engage in excessive care-seeking behaviors and maladaptive avoidance in some instances. In this case, we highlight the unique presentation of symptoms related to illness anxiety disorder and H. pylori infection. Furthermore, we discuss the possible psychosocial factors that are considered risk factors for developing IAD. We also discuss the pharmacological and psychological treatment options for patients with such a presentation.

Pandemic Grief Reaction and Intolerance of Uncertainty on the Cognitive-Behavioral Model of COVID-Related Hypochondriasis Among Firefighters

OBJECTIVE

This study aimed to explore the feasibility of cognitive-behavioral model hypochondriasis regarding coronavirus disease-2019 (COVID-19) among firefighters. In addition, we examined the possible role of their grief reaction and intolerance of uncertainty in the model of COVID-related hypochondriasis.

METHODS

An anonymous online survey was done on October 27-28, 2022, among firefighters who witnessed people's death. Demographic characteristics were collected, and their psychological states were assessed using rating scales such as the Obsession with COVID-19 Scale (OCS), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Fear of COVID-19 Scale (FCV-19S), Pandemic Grief Scale (PGS), and Intolerance of Uncertainty Scale-12 (IUS-12).

RESULTS

Their OCS score was expected by the CRBS (β=0.30, p<0.001), FCV-19S (β=0.10, p<0.001), PGS (β=0.29, p<0.001), and IUS12 (β=0.04, p=0.024) (F=134.5, p<0.001). The COVID-related cognitive-behavioral model of hypochondriasis was feasible among firefighters who witnessed people's death. Their pandemic grief reaction and intolerance of uncertainty directly influenced their preoccupation with coronavirus, and viral anxiety and coronavirus reassurance-seeking behavior mediated the relationship.

CONCLUSION

Firefighters' viral anxiety and coronavirus reassurance-seeking behavior mediated the influence of pandemic grief reaction or intolerance of uncertainty on the preoccupation with coronavirus.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

How cyberchondria and decision self-efficacy shapes the acceptability of COVID-19 vaccine: A gender-based comparison

Objective

Alarmingly, the individuals' reach and coverage to get vaccinated in developing regions during the pandemic is a massive challenge for concerned authorities. This study aimed to demonstrate how cyberchondria play a significant role in a classical health belief model. Cyberchondria may influence cognitive factors (e.g. self-efficacy), which may contribute to an increase in attitude-behavior gap. Especially in the context of a health-centric scenario, it may discourage individuals to take protective measures.

Method

By using the cross-sectional research design, the authors conducted a quantitative survey in Pakistan and collected 563 responses from 303 male respondents (rural = 91; urban = 212) with (Urban M:35.5, standard deviation (SD):13.4) and rural M:37.5, SD:8.4).

Result

The findings indicate that decision self-efficacy among males is stronger than that in females. It dominates other determinants, which can dampen the individuals' intentions to get vaccinated. For instance, the effect of conspiracies and perceived seriousness was noted nonsignificant and weak. In females, perceived seriousness was stronger determinant than in males. In addition, the negative effect of decision self-efficacy was noted in the case of females, and conspiracy and cyberchondria had a negative role.

Conclusion

This study highlights valuable implications for future research in infodemic, health communication and health literacy, and practical implications for regulatory bodies and public administration.

Exercise Participation during the COVID-19 Pandemic: Anxiety, Stress, and Precautionary Behavior

Understanding emotion is critical, as it influences behavioral responses. In particular, anxiety is one of the most significant factors affecting individuals' behavior during a pandemic situation. However, the effect of coronavirus anxiety on exercise behaviors has not been extensively explored in the extant literature. Therefore, this study examined the relationships among coronavirus anxiety, stress, precautionary behavior, and exercise participation. A total of 307 responses were collected from individuals who experienced the full length of the circuit breaker in Singapore. Data were analyzed using partial least squares structural equation modeling (PLS-SEM). Results showed that coronavirus anxiety had positive effects on stress and precautionary behavior. In addition, precautionary behavior played a mediating role in the relationships among coronavirus anxiety, stress, and exercise participation. The findings of this study identify how COVID-19 affected exercise participation during that period and suggest strategies to promote exercise participation, which would benefit individuals and governments.

Validation of the Korean Version of the Coronavirus Reassurance-Seeking Behaviors Scale During the COVID-19 Pandemic

OBJECTIVE

In this study, we aimed to develop a Korean version of the Coronavirus Reassurance-Seeking Behaviors Scale (CRBS) and to explore its reliability and validity among the general population in South Korea.

METHODS

Using an online survey conducted during November 9-15, 2021, we collected the demographic data of 400 individuals and their responses to rating scales such as the CRBS, the Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), the Generalized Anxiety Disorder-7 items (GAD-7), and the Patient Health Questionnaire-9 items (PHQ-9). We conducted factor analyses and utilized item response theory to confirm the validity and reliability of the Korean version of the CRBS.

RESULTS

Factor analyses revealed that the single factor model of the Korean version of the CRBS showed a good fit with the CRBS (χ2=5.475, df=5, p value=0.361, χ2/df=1.095, CFI=0.999, TLI=0.998, RMSEA=0.015). Multigroup CFA results indicated that the CRBS measures reassurance-seeking behaviors consistently across variables of sex, depression, general anxiety, and viral anxiety. The CRBS also exhibited good convergent validity with the SAVE-6 (r=0.431, p<0.001), GAD-7 (r=0.574, p<0.001), and PHQ-9 (r=0.575, p<0.001).

CONCLUSION

The CRBS is a reliable and valid rating scale that measures reassurance-seeking behavior in relation to viral epidemics.

Mediating Effects of Reassurance-Seeking Behavior or Obsession With COVID-19 on the Association Between Intolerance of Uncertainty and Viral Anxiety Among Healthcare Workers in Korea

BACKGROUND

This study explores whether the intolerance of uncertainty among healthcare workers prompts viral anxiety, and whether this association is mediated by their reassurance-seeking behavior and preoccupation with the coronavirus disease 2019 (COVID-19) in Korea.

METHODS

An online survey was conducted among healthcare workers in Asan Medical Center, on November 29, 2021. Demographic characteristics and responses to items from rating scales were collected, including Stress and Anxiety to Viral Epidemics-9, Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Obsession with COVID-19 Scale (OCS), Patient Health Questionnaire-9, Insomnia Severity Scale, and Intolerance of Uncertainty-12 (IUS-12).

RESULTS

Among the 329 participants, viral anxiety of healthcare workers was predicted by being female (β = 0.14, P = 0.002), CRBS (β = 0.30, P < 0.001), OCS (β = 0.32, P < 0.001), and IUS-12 (β = 0.15, P = 0.002) scores (adjusted R² = 0.43, F = 31.1, P < 0.001). Mediation analysis showed that the intolerance of uncertainty directly influenced viral anxiety, and reassurance-seeking behavior and obsession with COVID-19 partially mediated the association.

CONCLUSION

The intolerance of uncertainty among healthcare workers directly influenced their viral anxiety, and reassurance-seeking behavior and obsession with COVID-19 mediated this association in this era of "living with coronavirus" in Korea.

The Mediating Effect of Reassurance-Seeking Behavior on the Influence of Viral Anxiety and Depression on COVID-19 Obsession Among Medical Students

OBJECTIVES

Healthcare workers experienced great psychological burden due to the continuation of the COVID-19 pandemic. During the pandemic, medical healthcare workers experienced greater instances of insomnia, anxiety, depression, somatization, and obsessive-compulsive symptoms than the general population. This study aimed to explore the association between viral anxiety and obsession with COVID-19 among medical students with reassurance-seeking behavior as a mediator.

METHODS

In October 2021, an online survey was conducted among medical students at the University of Ulsan College of Medicine. The clinical characteristics of 162 participants and their responses to rating scales, including stress and anxiety to viral Epidemics-6 items (SAVE-6), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Patient Health Questionnaire-9 items (PHQ-9), and Obsession with COVID-19 scale were collected.

RESULTS

Medical students' obsession with COVID-19 was based on the PHQ-9 (β = 0.15, p = 0.01), SAVE-6 (β = 0.43, p < 0.001), and CRBS (β = 0.38, p < 0.001) scores (adjusted R² = 0.49, F = 39.9, p < 0.001). Mediation analysis showed that medical students' viral anxiety and depression directly influenced their obsession with COVID-19, and their reassurance-seeking behavior partially mediated the effects of depression or viral anxiety on obsession with COVID-19.

CONCLUSIONS

Medical students' viral anxiety and depression may affect their obsession with COVID-19, and reassurance-seeking behaviors may mediate this. Therefore, medical students should adopt adaptive coping strategies to prevent high levels of viral anxiety and recurrent reassurance-seeking behavior.