Academic literature on the topic 'Hypochondriasis'

Background and Objectives Hypochondriasis (Illness anxiety disorder) is one of somatic disorders where a person has a fear of having a serious disease for at least 6 months, despite having physical health. Its prevalence is higher in people aged 20-30 years. This study aims to determine the prevalence of hypochondriasis and its related factors during the COVID-19 pandemic in medical students of Mazandaran University of Medical Sciences (MUMS) Subjects and Methods This descriptive study with a cross-sectional design was conducted in 2021. The study population consists of all students of MUMS. Of these, 125 students participated in the study, including 75 females (60%) and 50 males (40%) aged 19-27 years (mean age=22.80±2.54 years). The data collection tool was a questionnaire adapted from a hypochondriasis awareness questionnaire developed by Evans in 1980. The collected data were analyzed in SPSS software, version 26. Results It was found that 36.8% had no hypochondriasis, 28% were at risk of hypochondriasis, 18.2% had mild hypochondriasis, 13.6% had moderate hypochondriasis, and 3.2% had severe hypochondriasis. The relationship between age and hypochondriasis was statistically significant (P=0.025). Conclusion Due to the COVID-19 pandemic and being in quarantine, most of the MUMS students has hypochondriasis, where older students have higher level of hypochondriasis.

Considering the lack of clarity in the conceptualisation of hypochondriasis, it is not surprising that the concept is quite heterogeneous and that there are dilemmas in terms of what is encompassed by hypochondriasis and where its boundaries are. Therefore, the aim of this review paper was to contribute towards a more coherent view on hypochondriasis, which would also allow its more adequate classification. The essential features of hypochondriasis were identified as an overvalued idea about the presence of disease, fear that the person has already become seriously ill, reassurance-seeking and other forms of health checking, and disturbances in the perception of bodily sensations and symptoms. These four aspects of hypochondriasis can be assessed dimensionally to ascertain to what extent they characterise each patient. Suggestions have been made to delineate more precisely hypochondriasis from health anxiety, anxiety disorders, obsessive-compulsive disorder, other somatoform disorders, personality disorders, depression, and delusional disorder with disease-related delusions. In the absence of better alternatives, hypochondriasis should continue to be classified among the somatoform disorders. In order to improve communication between clinicians and reduce conceptual heterogeneity, the term 'hypochondriasis' should be used to refer only to primary hypochondriasis. The pressure to abandon this term should be resisted until an adequate substitution for it has been found.

Hypochondriasis is a disorder that may affect ten percent of all individuals seeking medical care. This places a great burden on the health care resources that are currently available. Unfortunately, very few of these individuals come to the attention of mental health professionals. Various models have attempted to conceptualize hypochondriasis. These include the psychiatric model, the psychodynamic model, the social learning and the perceptual or cognitive abnormality model. The perceptual or cognitive abnormality model suggests that individuals who are hypochondriacal misinterpret and/or amplify normal bodily sensations. These processes lead the individuals to believe they are suffering from a serious disease. Few empirical studies have been conducted to confirm this model, and no research has been conducted testing this model using psychophysiological measures to test whether or not these indices are indeed different for non-hypochondriacal persons. Pain is a symptom often reported by hypochondriacs and this is what usually brings them into contact with the health care system. Being able to measure how hypochondriacs react to the experience of pain would give insight into whether or not they react more strongly to pain than do non-hypochondriacal persons. Although the objective measurement of pain has been considered difficult in the past, recent work by researchers using visual analogue scales have shown them to be valid and reliable instruments for measuring both the sensory and affective dimensions of the pain experience. The present study tested the perceptual and cognitive abnormality model of hypochondriasis using painful physical stimuli (heat stimulation and a cold pressor task) to measure subjects' pain tolerance and to rate their experience of pain. Subjects rated their pain experience on both sensory (intensity) and affective (unpleasantness) dimensions using visual analogue scales. The model was also tested using a psychological stressor, a visualization task which incorporated everyday life events. The psychophysiological measure heart rate was continuously recorded to assess subjects' physiological activity to stress. It was hypothesized that hypochondriacal individuals would withdraw their feet from the cold water bath, before being instructed to, at a significantly higher rate than the control group. It was also hypothesized that visual analogue scale ratings of intensity and unpleasantness would be significantly higher for the hypochondriacal group than for the control group for both cold pressor and thermal radiant heat. Further, it was hypothesized that the hypochondriacal group would exhibit increased heart rate, as well as a longer return to baseline time compared to the control group. In general, the data offered little support for the hypotheses used to test the amplification/misinterpretation components of the perceptual and cognitive abnormality model. Methodological problems with the study were discussed and improvements suggested. Also, problems and advantages of the present model were noted.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.<br>Introduction: There are few studies that examine the factors associated with the different levels of health anxiety in medical students. The objective was to determine the factors associated with the levels of health anxiety in medical students in 2018. Methods: An analytical cross-sectional study was carried out with 657 medical students from a private Peruvian university. Participants answered a questionnaire from which information was collected regarding levels of health anxiety (SHAI). For the analysis, linear regression was used to calculate crude and adjusted betas, and their 95% confidence intervals. Results: The mean health anxiety score was 14 ± 6.7. An association between health anxiety and the year of study is reported, with the second year showing the highest scores. In addition, an association between health anxiety and smoking is highlighted, as there are higher levels in occasional smokers, as well as a weak inverse correlation with age. No association was found with sex, place of birth, or having a first-degree relative that is a doctor or health worker. Conclusions: The present study showed that age, year of studies and smoking are associated with health anxiety levels. More studies are required, especially of a longitudinal nature.<br>Revisión por pares

DSM-IV-TR classifies hypochondriasis as a complex somatoform disorder, characterised by physical complaints for which no organic cause could be identified. DSM-5 replaced it with two new diagnostic terms: somatic symptoms disorder and illness anxiety disorder. The distinction was based on the presence or absence of somatic symptoms, and concerns have been raised with regards to the validity of these new diagnostic concepts. While there has recently been an increase in recognising the role of the underlying anxiety in this condition, the psychological needs of individuals with hypochondriasis remain unclear. It is conceivable that specific emotional and interpersonal dimensions play a mediating role in the onset of hypochondriacal presentations, and have explanatory power with regards to the improvement of tailored therapeutic interventions. The present study used a mixed methodology, with an emphasis on the qualitative component, to investigate emotions and the interpersonal aspects of hypochondriasis. Six young adult females meeting the diagnostic criteria for both DSM-IV-TR hypochondriasis and DSM-5 illness anxiety disorder formed a clinical group for the present study. Semi-structured interviews were administered and analysed in line with the Interpretative Phenomenological Analysis (IPA). Four major themes emerged from the qualitative data: 1) Early life experience; 2) Inward focus; 3) Learned helplessness; and 4) Experience of psychological therapy. Eight subordinate themes were identified: (i) Unmet emotional needs; (ii) Emotional isolation; (iii) There is something wrong with me; (iv) Emotional reasoning; (v) Self-fulfilling prophecy; (vi) External locus of control; (vii) Over-reliance on other people; and (viii) The experience of psychological therapy. Fifty-one female undergraduate psychology students formed a matched comparison group for the study and enabled a supplementary quantitative analysis to be conducted. The quantitative measures included measures of trait (TEIQue-SF) and ability emotional intelligence (MSCEIT) as well as a measure of sociotropy-autonomy (SAS). The quantitative data showed that the clinical group scored significantly lower than the comparison group on the measures of trait emotional intelligence, understanding emotions, and autonomy. Additionally, the clinical group scored significantly higher than the comparison group on the measure of sociotropy. The theoretical and therapeutic recommendations are discussed in light of the limitations of the present study. In conclusion, emotional and interpersonal aspects of DSM-IV-TR Hypochondriasis and DSM-5 illness anxiety disorder in young women provide a useful framework for the conceptualisation and therapeutic management of these conditions. It appears that with its scientific knowledge base, therapeutic flexibility, focus on reflective practice, and the emphasis on an effective working relationship, the discipline of counselling psychology is well-suited to address the needs of participants with hypochondriacal presentations.

<p>Background: Hypochondriasis is associated with marked impairments in physical and psychological functioning, work performance and increased health care utilization. The prevalence among medical outpatients is estimated to be between 4,2 % and 6,3 %. Notwithstanding there is deficient research in this area. Until recently no specific treatment has been clearly demonstrated to be effective. Objective: The aim was to investigate experiences of what it is like to live with hypochondriasis, but also to examine different treatment options. Methods: In order to illustrate the experiences a latent content analyses was made on a documentary named “Hypokondrikerna” and to examine the treatment options a systematic review was made. Result: The content analysis revealed three categories and nine sub-categories concerning the experiences. The three categories were “health anxiety”, “individual coping strategies” and “emotional consequences”. The systematic review revealed medical treatment which consisted of three different antidepressants as well as seven different kinds of psychological treatments and other interventions, which all reduced hypocondriacal symptoms. Discussion: The findings show that hypochondriasis causes a chronic suffering and indicates that potential treatments are available. Hypochondriasis causes an unproductive health care utilization. A more effective management could reduce the costs and ease the suffering. Therefore we suggest that this disease should be observed and treated. The nurse has an important function to maintain a positive relationship with the patient and create a therapeutic dialogue.</p>

Cognitive behavioural theory suggests that excessive use of the Internet for health purposes can contribute to health anxiety but previous research examining the relationship between health anxiety and health-related Internet use is limited. This thesis aimed to explore if and how health-related Internet utilization and health anxiety are related, and whether such Internet use can exacerbate the health anxiety of health anxious individuals. Study 1 aimed to examine the possible relationship between health anxiety and the extent of, reasons for, and effects of health-related Internet use in university students, using a bespoke, theory-based questionnaire. Results suggested that health anxiety was significantly related to heightened and potentially problematic health-related Internet use, including: more frequent use, a greater proportion of health (vs. non-health) information sought, more time spent online for health purposes, more searches for illness information, and heightened tension post-search. We also found correlations between health anxiety and six-items concerning possible Internet addiction for health purposes. Study 2 sought to obtain information about health anxious individuals’ perspectives on health-related Internet use, using qualitative methodology. Themes uncovered during analysis were consistent with the results of study 1, and highlighted several other aspects of health-related Internet use that were relevant to health anxious users, including: metacognitions, Internet disadvantages, and health anxiety for others etc. Study 3 used the results of studies 1 and 2 to develop and psychometrically evaluate a new Internet use questionnaire in a large, non-clinical sample. Results suggested that the measure was both valid and reliable. Spearman correlations and simultaneous regressions substantiated previous findings from our earlier studies. Three aspects of health- related Internet use were uniquely predictive of health anxiety (illness-related Internet use: self; problematic use of the Internet for health purposes; anxiety post-search/perceived adverse consequences of searching). Study 4 aimed to determine the effects of presenting online health information in a manner designed to facilitate disconfirmatory information processing on subsequent anxiety, worry and illness beliefs. Results suggested that facilitating disconfirmatory information in this way was ineffective in reducing negative emotional outcomes post-search. Study 5 compared the frequency of ‘query escalations’ (searches for common, benign symptoms escalating to the consideration of serious causes/diseases) during online health searches between high and low health anxious students. We also examined the participants’ rationale for escalating queries and the effects of escalating on anxiety. Results found instances of query escalation in both high and low health anxious groups; though high health anxious participants were more likely to escalate their queries. Both groups reported increased anxiety post-escalation. In the final chapter I briefly summarise our studies, discuss major findings and the implications of our research, critically appraise our methodology, choices, and studies, and make recommendations for future research in this area.

This paper reviews the prevalence, characteristics, comorbidity, and care of hypochondriac patients in primary care samples in Saxony. Patients with health anxieties don’t get much attention in terms of care and supply due to a lack of knowledge regarding treatment strategies of this health disorder, but also because it is perceived as innocuous in itself by family doctors. On the other hand these patients create high personal and communicative expenditures for the caregiver and high expenses for the healthcare system due to diagnosis and treatment seeking of those patients. The study was performed predominantly in the cities of Saxony at patients consulting their family doctors for any purpose on a randomly chosen testing day and revealed a rate of 10.5% hypochondriac patients. The demographic patient characterization matches the available literature, considering the two determining factors “screened population” and “diagnostic instrument”. There was no gender predominance noticeable; marital status did also not have any impact on the development of hypochondria. A higher age was the strongest associated demographic risk marker for developing health anxiety. A higher educational level is associated with lower levels of hypochondriasis with more impact than the current job situation. The high number of retired patients in the study limits the statistical power of job-associated variables. The most important and prominent comorbidity was depression, followed by panic disorders, matching also with available literature. The overall somatic morbidity of the patients was low. One positive finding of our study was a high stability of the physician-patient relationship over many years. Hypochondriac patients consult their doctors more often, get longer lasting visits, and require more specialist consultations than other patients. The majority of physicians diagnose the psychological disorders of a hypochondriac patient and recommend psychotherapy. Patient´s self-perception differs slightly from the physicians´ evaluation; they may understand the need of a therapy but don´t bring up enough motivation for realizing it. That’s where the dilemma for family doctors starts because they have no problems of diagnosing health anxieties but are not provided with professional tools for a time- and resource effective management of hypochondriac patients. The enormous time pressure in daily clinical practice provokes ignoring of hypochondriac patients and just an attempt of a reserved transfer practice to specialists, which the patients usually handle by transferring themselves. Considering the availability of more efficient screening tools and therapy strategies, practical aid for professional contact with hypochondria patients by family doctors would be desirable and needed. Those should on the one hand help evaluate patients at risk for depression, and also introduce them to therapy, and on the other hand help general practitioners with communication strategies for hypochondria patients to make them understand the need of therapy. Hypochondriasis in education- or advanced training curriculum for general practitioners is explained way too short. Especially requirements concerning the family doctors’ professional communication skills to deal with hypochondria patients are enormous and could eventually be improved by either specialized psychotherapists or through further training programs. This could save costs for multiple diagnostic screenings of patients on the long-term. The study illustrates the interest of family doctors for health anxiety disorders and the topic’s practical relevance. The appropriate medical societies are asked to create training programmes for family doctors and to improve the interface between family doctors and psychotherapists regarding the treatment of hypochondriasis. This work does not cover the impact of digital media on the prevalence of health anxieties. The internet provides a huge amount of unfiltered medical information and leaves patients alone processing with that knowledge. Physicians are challenged by the patients to put the information in a correct perspective to the patients’ individual medical situation. Scientific data about the impact of digital media on the prevalence and course of health anxiety are missing. Research on this topic seems being complex due to the heterogeneity of the interacting internal and external factors. It can be assumed, that the influence of the plentiful medical “superficial knowledge” available from the internet will increasingly influence physicians´ and hypochondriac patients´ interaction. The need of a scientific evaluation of this subject, including the development of professional communication strategies for family doctors with hypochondriac patients has been addressed to the responsible psychological research facilities. Family doctors emphasized the particular need of an improved interface between primary care and specialized psychological treatment for hypochondriac patients. Quickly retrievable communication tools for strategical contact with those patients are demanded. May this study contribute to an increased awareness and an installation of research programmes dealing with this disorder<br>Die vorliegende Arbeit stellt eine epidemiologische Erhebung zur Prävalenz, Charakteristik, Komorbidität und Versorgung hypochondrischer Patienten in einem hausärztlichen Patientengut im Land Sachsen dar. Patienten mit Krankheitsängsten erhalten aktuell wenig Aufmerksamkeit in der Versorgungsforschung, da die Krankheit per se als gutartig bei Hausärztinnen und Hausärzten wahrgenommen wird und wenig Wissen zum professionellen Umgang mit solchen Patienten vorhanden ist. Damit inadäquat korrelierend sind die zum Teil hohen Kosten, die solche Patienten durch Überdiagnostik für das Gesundheitssystem verursachen und der hohe personelle und kommunikative Aufwand, der durch diese Patienten für den jeweiligen Hausarzt entsteht. Die Erhebung erfolgte vorwiegend in sächsischen Großstädten und erfasst eine Rate von 10,5% hypochondrischer Patienten in einem unselektierten, allgemeinmedizinischen Patientengut, die wegen beliebiger Beschwerden am jeweiligen Erhebungsstichtag den Hausarzt aufsuchten. Die demografischen Patientencharakteristika stimmen mit der vorliegenden Literatur überein, wenn man die entscheidenden Faktoren „Screeningpopulation“ und „Diagnoseinstrument“ berücksichtigt. Es liegt im Wesentlichen eine Gleichverteilung der Geschlechter vor, auch der Familienstand spielt keine nennenswerte Rolle für die Ausprägung einer Hypochondrie. Einzig ein höheres Alter lässt die Wahrscheinlichkeit pathologischer Krankheitsängste ansteigen. Die Abhängigkeit vom Bildungsgrad ist deutlicher als die von der aktuellen beruflichen Situation, wobei der große Anteil Rentner in der Erhebung die Aussagefähigkeit hierzu einschränkt. Als wichtigste auffällige Komorbidität fand sich die Depression, gefolgt von Panikstörungen, auch dies stimmt mit Daten aus der Literatur überein. Die somatische Morbidität der Patienten zeigte sich insgesamt eher niedrig. Positiv fällt eine hohe Stabilität der Arzt – Patientenbeziehung über viele Jahre in der gesamten untersuchten Patientenpopulation bei den teilnehmenden Ärzten auf. Hypochondrische Patienten weisen längere Visitenzeiten und gehäufte Arztkonsultationen auf als andere Patienten und werden häufiger zu anderen Fachrichtungen überwiesen. Die Ärzte erfassten in einem hohen Ausmaß die Störung der Patienten und stellten die Indikation für eine psychotherapeutische Mitbehandlung. Die Selbstwahrnehmung der Patienten stellte sich naturgemäß anders dar, der Therapiebedarf wird zum Teil von den betroffenen Patienten zwar gesehen, die Motivation hierzu dennoch als wenig ausgeprägt dokumentiert. Hier beginnt das Dilemma der Hausärzte, die offensichtlich geringe Probleme in der Detektion pathologischer Krankheitsängste haben, aber ohne strategisches Rüstzeug das zeit- und ressourcenträchtige Management dieser Patienten bewältigen müssen. Oft genug führt der enorme Praxisalltagsdruck zu einem „Wegschauen“ und allenfalls Versuch der zurückhaltenden Überweisungspraxis, die der Patient vermutlich oft genug durch Eigeninitiative zu umgehen versteht. Angesichts verfügbarer effizienter Screeningtools und Therapiestrategien wären praktische Hilfen zum professionellen Umgang von Hausärzten mit hypochondrischen Patienten wünschenswert. Diese sollten einerseits helfen, Risikopatienten für eine Depression frühzeitig zu evaluieren und einer Therapie zuzuführen und andererseits Kommunikationsstrategien für Allgemeinmediziner zum Umgang mit hypochondrieverdächtigen Patienten und zum Erreichen einer Krankheits- und Therapieeinsicht beinhalten. In Ausbildungs- bzw. Fortbildungscurricula für Allgemeinmediziner kommt dieses Thema bislang zu kurz. Insbesondere die Anforderungen an die kommunikativen Fähigkeiten des Hausarztes im Umgang mit hypochondrischen Patienten sind enorm und könnten durch spezialisierte Psychotherapeuten aufbereitet und in Weiterbildungsprogrammen geschult werden. Beginnen sollte dieser Prozess bereits frühzeitig im Medizinstudium. Wie sich allein an der Anzahl der Überweisungen zu Fachärzten zeigt, ist die Hypochondrie keinesfalls nur ein hausärztliches Thema. Mittel- bis langfristig wäre dies sicher kosteneffizient durch Einsparung der Kosten für Doppel-und Vielfachuntersuchungen dieser Patienten. Unsere Erhebung zeigt das Interesse der Hausärzte und die praktische Relevanz des Themas. Die entsprechenden Fachgesellschaften sind hier gefragt, sich neben der fachlichen Fortbildung der Hausärzte der Schaffung von Versorgungstrukturen zur Verbesserung der Schnittstelle Hausarzt - Psychotherapeut anzunehmen. Bewusst nicht thematisiert wurde in der vorliegenden Arbeit der Einfluss des Internets und der sogenannten „neuen“ Medien auf die Prävalenz krankheitsbedingter Ängste. Dieses Gebiet stellt eine zunehmende Herausforderung an Hausärzte und Patienten bezüglich des Umgangs mit der damit verbundenen Informationsflut dar. Wissenschaftliche Daten zu den Auswirkungen der digitalen Medien auf die Prävalenz und den Verlauf krankheitsbedingter Ängste fehlen bisher, eine wissenschaftliche Evaluation erscheint aufgrund der Heterogenität und schwierigen kausalen Abgrenzbarkeit interner von externen Einflussfaktoren komplex. Nichtdestotrotz ist anzunehmen, dass der Einfluss des massenhaft verfügbaren medizinischen „Halbwissens“ aus dem Internet spürbar Hausärzte und ihren Umgang mit hypochondrischen Patienten beeinflussen wird

Antecedentes: Existen pocos estudios que examinen los factores asociados a los distintos niveles ansiedad por la salud en los estudiantes de medicina. Objetivos: Determinar los factores asociados a los niveles de ansiedad por la salud en estudiantes de medicina en el año 2018. Materiales y métodos: Se realizó un estudio transversal analítico con 657 estudiantes de medicina de una universidad privada peruana. Se realizó un censo y los participantes respondieron un cuestionario donde se recopiló la información respecto a los niveles de ansiedad por la salud (SHAI). Para el análisis se empleó la Regresión Lineal para calcular los betas, crudos y ajustados, e intervalos de confianza al 95%. Resultados: El promedio del puntaje de ansiedad por la salud fue de 14 puntos (SD 6,7). Se reporta una asociación entre la ansiedad por la salud y el año de estudio, siendo el segundo año el que revela puntajes más altos. Además, pone en manifiesto la asociación entre la ansiedad por la salud y el uso de tabaco, reportando niveles más altos en los fumadores ocasionales; así como una correlación inversa débil con la edad. No se revela asociación con el sexo, el lugar de nacimiento, el tener un familiar de primer grado médico o el tener un familiar de primer grado personal de salud. Conclusiones: El presente estudio evidenció que la edad, el año de estudios y el uso de tabaco se encontraban asociados a los niveles de ansiedad por la salud. Se requieren más estudios, especialmente de naturaleza longitudinal.<br>Background: There are few studies that examine the factors associated with the different levels of health anxiety in medical students. Objectives: To determine the factors associated with the levels of health anxiety in medical students in 2018. Methods: An analytical cross-sectional study was carried out with 657 medical students from a private Peruvian university. A census was conducted and the participants answered a questionnaire where information was collected regarding the levels of health anxiety (SHAI). For the analysis, Linear Regression was used to calculate crude and adjusted betas and 95% confidence intervals. Results: The mean score was 14 points (SD 6,7) for health anxiety. An association between health anxiety and the year of study is reported, with the second year showing the highest scores. In addition, it highlights the association between health anxiety and the use of tobacco, reporting higher levels in occasional smokers; as well as a weak inverse correlation with age. No association with sex, place of birth, having a family member of first degree doctor or having a family member of first degree health personnel is revealed. Conclusions: The present study showed that age, year of studies and tobacco use were associated with health anxiety levels. More studies are required, especially of a longitudinal nature.<br>Tesis