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The COVID-19 pandemic possesses challenges for individuals with preexisting mental health conditions, such as those with obsessive-compulsive disorder (OCD) and Illness Anxiety Disorder. Amid the novel coronavirus pandemic, sanitary precautions have become encouraged. Mental health practitioners need to examine how the normalization of these practices may become triggers and reinforcements for obsessive thinking and compulsive behaviors. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Nickel (Ni) oral hyposensitization treatment (NiOHT) is an effective management approach for Ni allergy. No health-related quality of life (HRQoL) data exist for the pre- and post-treatment with NiOHT in systemic nickel allergy syndrome (SNAS). The aims of this study were (a) to explore HRQoL in SNAS patients, (b) to assess changes of HRQoL after 1 year of NiOHT; (c) to evaluate psychological status of patients. SNAS patients completed the Short-Form 36-Item Health Survey and Psychological General Well-Being Index before and 1 week after the end of NiOHT. Moreover, psychological state was assessed with the Minnesota Multiphasic Personality Inventory (MMPI-2). A total of 52 patients self-reported pre- and post-treatment questionnaires. HRQoL was poor at baseline. After 1 year of NiOHT, all outcome measure scores improved by about 20% with respect to baseline data ( P  < 0.01 for all indices, except depressed mood). Finally, 33 patients performed the MMPI-2. High rates for hypochondriasis and depression were noted. Furthermore, most of the patients had high scores for anxiety, depression, and health concerns. This is the first study showing that NiOHT improves HRQoL of SNAS patients, which can be considered a "personalized medicine" approach.

Both cenestopathies (abnormal body sensations) and hypochondriac symptoms can occur in both acute and chronic psychotic disorders. The present article will brie?y describe some psychotic pictures that may accompanied with cenestopathies and/ or hypochondriacal symptoms. All descriptions will be illustrated with clinical examples to facilitate the understanding and delimitation of these diseases.

Based on the results of a comprehensive study of 35 people aged from 19 to 52 years, among them 20 women and 15 men with celiac disease features of their physiological status were studied, reflecting the severity of the disease and quality of life. The diagnosis was based on the clinical and anamnestic data, endoscopy, histomorphological, immunological and genetic exams. Psychophysiological analysis showed that in celiac disease is characterized by the formation reactions with anxiety, anxiety-phobic, neurotic, affective, and hypochondriacal symptoms. The results of the study emphasized the importance of adaptive physiological capacity of the body to build tolerance to the development of psycho-vegetative, hypochondriacaldepressive and other disorders.

Objective: Previous studies demonstrated that a history of childhood trauma is linked to mental disorders in adulthood, particularly to depression. Adverse childhood experiences are also considered to contribute to the risk of hypochondriasis, but the results of previous studies have not been conclusive with respect to the strength and specificity of this association. Therefore, we compared the association of adverse childhood experiences with both hypochondriasis and depression., Methods: Fifty-eight patients with hypochondriasis, 52 patients with depression, and 52 healthy control participants completed the Childhood Trauma Questionnaire (CTQ) which assesses 5 varieties of abuse and neglect. A clinical interview (SCID-I) was used to establish DSM-IV diagnoses. Associations between childhood maltreatment, hypochondriasis and depression were estimated by means of analyses of variance and multiple linear regression analyses., Results: In comparison to hypochondriacal and healthy participants, patients with a current depressive disorder reported more emotional abuse as well as more emotional and physical neglect during childhood. Patients with hypochondriasis reported more emotional neglect than healthy individuals. However, when predicting the CTQ trauma types by diagnostic category adjusting for sex and comorbid DSM-IV diagnoses, emotional abuse, emotional neglect, physical abuse, physical neglect, as well as the CTQ total score were significantly associated with depression, but none of the CTQ scores was significantly related to hypochondriasis., Conclusions: The findings suggest a robust association of childhood maltreatment with depression but not with hypochondriasis. This result does not support etiological models of hypochondriasis which rely on childhood maltreatment as a risk factor for the development of this disorder., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: Previous experiences with illness and traumatic experiences are considered as important risk factors for the development of health anxiety and hypochondriasis. However, empirical research is insufficient and lacks adequate comparison groups., Objective: Therefore, we sought to determine whether experiences with illness and traumatic experiences are really specific risk factors for hypochondriasis., Method: In the current study, patients with the diagnosis of hypochondriasis (n = 80), patients with a primary anxiety disorder (n = 80), and healthy controls (n = 83) were investigated regarding their previous experiences with illness (self and other) and traumatic childhood experiences., Results: We found that patients with hypochondriasis reported a higher level of experience with illness and with traumatic childhood experiences than healthy controls. However, no differences were found between patients with hypochondriasis and those with an anxiety disorder, regarding their level of experience with illness and traumatic experiences., Conclusions: Previous experiences with illness and traumatic childhood experiences did not prove to be specific risk factors for the development of hypochondriasis. The importance of both experiences with illness and traumatic experiences as risk factors, as considered in the Diagnostic and Statistical Manual and in established cognitive-behavioral models, does not seem to be supported empirically. Further research should therefore also consider other potential risk factors discussed in the literature., (© 2013 Published by Academy of Psychosomatic Medicine on behalf of Academy of Psychosomatic Medicine.)

Aim: To investigate anxiety and depression propensities in patients with toxic liver injury., Methods: The subjects were divided into three groups: a healthy control group (Group 1, n = 125), an acute non-toxic liver injury group (Group 2, n = 124), and a group with acute toxic liver injury group caused by non-commercial herbal preparations (Group 3, n = 126). These three groups were compared and evaluated through questionnaire surveys and using the Hospital Anxiety-Depression Scale (HADS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and the hypochondriasis scale., Results: The HADS anxiety subscale was 4.9 ± 2.7, 5.0 ± 3.0 and 5.6 ± 3.4, in Groups 1, 2, and 3, respectively. The HADS depression subscale in Group 3 showed the most significant score (5.2 ± 3.2, 6.4 ± 3.4 and 7.2 ± 3.4 in Groups 1, 2, and 3, respectively) (P < 0.01 vs Group 1, P < 0.05 vs Group 2). The BAI and BDI in Group 3 showed the most significant score (7.0 ± 6.3 and 6.9 ± 6.9, 9.5 ± 8.6 and 8.8 ± 7.3, 10.7 ± 7.2 and 11.6 ± 8.5 in Groups 1, 2, and 3, respectively) (BAI: P < 0.01 vs Group 1, P < 0.05 vs Group 2) (BDI: P < 0.01 vs Group 1 and 2). Group 3 showed a significantly higher hypochondriasis score (8.2 ± 6.0, 11.6 ± 7.5 and 13.1 ± 6.5 in Groups 1, 2, and 3, respectively) (P < 0.01 vs Group 1, P < 0.05 vs Group 2)., Conclusion: Psychological factors that present vulnerability to the temptation to use alternative medicines, such as herbs and plant preparations, are important for understanding toxic liver injury.

The Diagnostic Criteria for Psychosomatic Research (DCPR) were introduced in 1995 by an international group of investigators to expand the traditional domains of the disease model. The DCPR are a set of 12 'psychosomatic syndromes' which provide operational tools for psychosocial variables with prognostic and therapeutic implications in clinical settings. Eight syndromes concern the main manifestations of abnormal illness behaviour: somatization, hypochondriacal fears and beliefs, and illness denial. The other four syndromes (alexithymia, type A behaviour, demoralization and irritable mood) refer to the domain of psychological factors affecting medical conditions. This review describes the conceptual bases of the DCPR and the main findings concerning their application, with particular reference to the incremental information they added to the customary psychiatric classification. The DCPR were also compared with the provisional DSM-5 somatic symptom disorders. The DCPR were found to be more sensitive than DSM-IV in identifying subthreshold psychological distress and characterizing patients' psychological response to medical illness. DSM-5 somatic symptom disorders seem to neglect important clinical phenomena, such as illness denial, resulting in a narrow view of patients' functioning. The additional information provided by the DCPR may enhance the decision-making process.

Authors studied 276 women with late-onset depression. Concomitant chronic somatic diseases were identified in 90%. The presence of disease and its nosological definition did not impact on the development of hypochondriac symptoms in patients with late-onset depression. Patients with hypochondriac late-onset depression more often had disability pension due to somatic disease because they more often referred to internists in case of similar objective severity of somatic pathology. It was singled out three variants of the relationship between hypochondria and somatic state: hypernosognostic (a complete coincidence of hypochondria content with actual somatic pathology; anosognostic (a lack of coincidence) and disharmonic (a partial coincidence). The themes of hypochondria in late-nset depressions were correlated with a total number of somatic diseases and their severity. At the same time, there was no correlation between the content of hypochondria and the character of somatic disease.

The features of severe health anxiety, intense and persistent anxiety about one's present and future health, are described. In common with other anxiety disorders such as GAD, PTSD and OCD, the core of HAD is distressing, uncontrollable anxiety, and is classifiable as an Anxiety Disorder, Health Anxiety Disorder (HAD). The cognitive construal of HAD proposes that health anxiety is caused by catastrophic misinterpretations of the significance of sensations and/or changes in bodily functions and appearance (such as swellings, pain, loss of energy, dizzy spells). The nature, causes, triggers, persistence, assessment and treatment of HAD are reviewed, and the present status of the cognitive model is appraised. Suggestions are made for future research and clinical applications, and the need for incisive evaluations of the main premises of the model is emphasized., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The aim of this work was to study clinical and pathogenetic aspects of depression associated with Alzheimer disease (AD) in 65 patients. Depressive symptoms are shown to frequently occur in all types of the disease and at all stages of its therapy. A variety of syndromic variants of depression are identified in the structure of dementia: anxiety (35.4%), apathetic (29.2%), delusional (16.9%), hypochondriac (10.8%), melancholic (7.7%). Situation-reactive, endoreactive, and endogenous types of depression were distinguished depending on its pathogenetic mechanisms. Great variety of clinical and psychopathological manifestations and mechanisms of depressive pathology in AD suggests its heterogeneous character.

Long-sanding depressions are defined as protracted depressive conditions lasting at least 2 years with subsequent spontaneous or therapeutic high-quality remission (intermission) and fully reversed depressive disorders, recovery of the premorbid psychic functions, personality traits and quality of life. Two variants of long-standing depressions, simple and polymorphic, are distinguished based on peculiarities of the psychopathological structure. The practicability of classification of long-standing depressions and their dynamics by phase states is discussed. Chronic depressive states are distinctive for well-apparent polymorphism of disorders and gradual aggravation of depressive symptoms up to neurosis-like and delusional register without a tendency toward spontaneous normalization and with only low-quality therapeutic remission with residual productive symptomatology. Four types of chronic depressions are distinguished: melancholic, apathoadynamic, depressive-hypochondriac, and depressive-depersonalizing. Three variants of dynamics of chronic depressions are described: dynamic-inert, dynamic-labile, and dynamic with continuous aggravation of the disorder. The appropriateness of discussion of chronic depressions in terms of protracted progressive attacks and conservation of their psychopathological basis throughout the period of the disease is considered. The principles of therapy of long-standing and chronic endogenous depressions are briefly outlined.

After having studied the history of hypochondria from antiquity until today, the author proposes a psychopathological reading of hypochondriac fenomena, in the light of Freud and Lacan's works.

Anxiety or masked depression are often associated with somatisation in elderly. Hypochondriasis is an excessive preoccupation or worry about having a serious illness. The DSM-IV defines it as a somatoform disorder. It affects about 3% of the population but has a heavy health care cost. Depression, obsessive-compulsive disorder generalized anxiety and somatization disorder are common in elderly and are the most common accompanying conditions in people with hypochondriasis. Old persons' unexplained medical symptoms in generalized anxiety and their relationship to the somatoform disorders are presented. Supportive care and psychotherapy are as necessary as antidepressant to help patients.

The study was undertaken to evaluate the emotional-and-personality sphere in patients with psoriasis concurrent with chronic opisthorchiasis (CO). A hundred and fifty patients with psoriasis concurrent with CO, 100 psoriatic patients without helminthiasis, 100 patients with CO, and 30 healthy individuals were examined. The SMOL test was used to evaluate the emotional-and-personality sphere. Clinical and psychological studies of patients with psoriasis alone and in combination with CO revealed unidirectional psychoemotional (mainly hypochondriacal) changes in patients in these groups. However, anxiety and hypochondriac disorders were clinically significant in patients with comorbidity (psoriasis + CO). This suggests that Opisthorchis invasion is of considerable importance in the genesis of these changes and requires medical correction of helminthiasis.

Approximately 13% of physician visits are for medically unexplained physical symptoms (MUPS), and up to 25% of patients report MUPS during visits to the doctor. Most of these patients' symptoms abate. But approximately 5% of patients are convinced they have a serious disease, although no problem can be diagnosed; these individuals are considered to be individuals with hypochondria. Estimates indicate they consume at least 10% of health care dollars and frustrate health care professionals. Treatment is possible, but paradoxical in nature. Clinicians must accept that the patient's concerns are real, and respect the patient's psychological defenses.

Based on a clinical follow-up observation of 20 patients with dissocial personality disorder, a particular variant of prolonged hypochondriac state (postaddictive hypochondriasis) has been singled out. Postaddictive hypochondriasis manifests itself after a transient psychosis arising as an existential crisis. It is a syndrome of nondelusional hypochondriasis, with a clinical picture presented by obsessive thoughts of the damage to mental and/or somatic well-being caused by the illness which are combined with a phenomenon of medical addiction. Postaddictive hypochondriasis is formed as an opposite/reversive phenomenon replacing premorbid addictions by means of antinomic shift. The sample has been stratified into two groups depending on disease course and comorbid disorders. In the first group (n=7), postaddictive hypochondriasis manifests itself in the structure of reversible psychopathic phases and pathologic personality developments. It is not accompanied by a social disability and considered to be a representation of personality disorder dynamics. In contrast, postaddictive hypochondriasis in the second group (n=13) is characterized by chronic disease pattern and a variety of comorbid disorders including additional hypochondriac, phobic and affective syndromes. Postaddictive hypochondriasis in this group is considered as a debut of slow progressive pseudopsychopathic schizophrenia (schizotypic disorder).

The typology of hypochondrical development of personality is presented on the basis of observation of 142 patients, 82 males and 60 females, mean age 45,7+/-3,8 years, with cardiac, dermatological and oncologic pathologies. 7 types of hypochondrical development of personality were singled out as paranoiac, aberrant type, overvalued, neurotic, masked hypochondria, "new life" type and hypochondrical dysthymia, and patterns of their formation were specified. Assessment of the contribution of a constitutional personality or somatic pathology to the clinical presentations and dynamics of personality disorders revealed that in some cases a personality disorder and a somatic disease interacted as equals separately (the hypochondrical development, neurotic and masked hypochondria types); in others cases, there was the distinct parallelism in the influence of the somatic factor and constitutional predisposition (paranoiac type, the development of personality pathology by the types of aberrant or overvalued hypochondria) or symptoms were completely determined by a somatic factor ("new life" and hypochondrical dysthymia types).

Objective: The present study was designed to investigate the influence of viral myocarditis on mental behavior of the children., Methods: Mentality and behavior of the 178 children suffering from viral myocarditis were examined with Achenbach Child Behavior Checklist (CBCL) edited by Gong Yao-xian in 1986 and 104 sex, age, education and achievement-matched children with pneumonia or upper respiratory infection were enrolled as controls., Results: The mentality and behavior of the children with viral myocarditis were distinctly abnormal. The abnormal rates of boys and girls suffering from acute and deferment viral myocarditis were evidently higher than those of control children (P < 0.01). The behavioral abnormalities of boys were hypochondria, social difficulties, unwell of body and attack. Whereas, the girls presented hypochondria, unwell of body, social flinch and disobeyed discipline, which was significantly different from the control children. The total and hypochondria cursory mark of the second check result of deferment boys were evidently higher than those of the first check (P < 0.05). The total cursory mark of the second check result of deferment girls was higher than that of the first check (P < 0.05) and evidently higher than that of the acute second check result (P < 0.01). The abnormal rates of mentality and behavior correlated positively with the age of children and they were associated with the severity of the illness., Conclusion: Viral myocarditis evidently affected the mentality and behavior of children, which should be paid great attention to.

Psychiatric symptoms are common in Huntington's disease and can occur years before the motor symptoms. We present an unusual case that presented as a hypochondriac disorder fourteen years before the appearance of choreic movements.

Objective: To compare the clinical manifestation of depressive disorder in elderly, and younger adults., Methods: To compare the clinical manifestation of depressive disorder, we evaluate 46 elderly (33 female, and 13 male, mean age 71.1) and 60 younger adults (40 female, and 20 male, mean age 44.5 years). All patients suffering from depressive disorders according to ICD-10. For evaluation and comparison of depressive symptomatology we used the HAM-D-17. The results analysed by the SPSS., Results: The clinical manifestation of depression is different in the elderly. Elderly depressed patients compared with their younger counterparts, scored significantly less in Depressed mood, but significantly higher in Work and activities, Retardation, Somatic symptoms-general, Hypochondriasis, Insomnia-middle, Insomnia-late, Anxiety-somatic, and Somatic symptoms-gastrointestinal. On the other hand, younger patients scored significantly higher in Feelings of guilt, and Genital symptoms., Conclusions: Clinical presentation of depressive disorder is different in the elderly, depressed mood is often absent or masked. Anxiety, somatization, and hypochondriasis are more often present in the elderly depressed patients than in younger patients. The elderly people are also more likely than their younger counterparts to complain of insomnia.

Forty patients (37 women, 3 men, age 47.3 +/- 3.4 years) with diagnosis of involutional hysteria (IH) have been studied. Two variants of IH have been identified. The first one, hystero-hypochondriac, is characterized by a prevalence of conversions, asthenia and hypochondria; the second--by hysterical depression, overvalued erotomania with premorbid histrionic personality disorder. The hypochondriac variant of IH is triggered by somatogenic disorders (gynecological surgeries, cardiovascular diseases) as well as various psychogenic factors (conflicts in professional and family life). Manifestation of the second variant is realized by the mechanism of key feeling, with trigger factors related to the objects of overvalued events (adultery, break-up of love affairs).

Objective: The aim was to examine the influence of combat exposure and other risk factors on the development of hypochondriacal concerns among veterans of the Gulf War and to learn whether these concerns might be a source of increased symptom reporting among them., Method: Six hundred two veterans who were deployed to the Gulf or elsewhere during the 1991 war took part in a two-phase study of symptoms and illnesses occurring among these veterans. Hypochondriacal beliefs and attitudes were assessed by the Whiteley Index and somatic symptoms by a factor-analytically derived measure. Multiple regression models were developed for these outcomes., Results: Hypochondriacal concerns were significantly associated with level of education, personal history of depression, number of prewar physical conditions, family history of functional syndromes, negative and positive temperament and disinhibition, military combat, level of military preparedness, social support, and perceived life stress. Somatic symptoms were associated with these same variables, as well as branch of service, family history of physical conditions, combat, and level of combat exposure. A regression model for hypochondriacal concerns included the number of prewar physical conditions, negative temperament, lack of social support, and perceived life stress., Conclusions: Hypochondriacal concerns were not strongly related to combat exposure. Consequently, it is not likely that such concerns account for increased symptom reporting among the veterans studied. Hypochondriacal concerns appeared to arise in response to threats posed by physical illness. Vulnerability to such threats appeared to center on the personality dimension of negative temperament. This model may serve as a guide to future investigations.

Four hundred and twenty patients admitted to the veteran's hospital with neuro- and psychopathology have been examined. Along with clinical, neurological, psychiatric and psychological methods, electroencephalography, computed tomography, electrocardiography, ultrasonic and X-ray methods for nervous system investigation as well as biochemical and immunological blood examination were used. The following disorders were singled out: (1) mental disorders--neurosis, personality pathology, post-traumatic stress disorder and different types of addictions (alcoholism, drug dependence): (2) consequences of craniocerebral and other injuries; (3) psychosomatic pathology. The prevalence, clinical manifestations and dynamics of each group of disorders are studied and their patho- and sanogenesis in terms of theory of functional systems are regarded.

According to the interpersonal model of hypochondriasis, early environmental adversity may give rise to attachment insecurity that finds adult expression in care-seeking behavior. To identify antecedents of this disturbance, we interviewed general medicine patients and obtained from them self-reports of traumatic events, adverse circumstances, and symptoms experienced in childhood. Patients who met DSM-III-R criteria for hypochondriasis more often reported traumatic events and circumstances, including serious illness or injury. Among all patients, the level of hypochondriacal symptoms in adulthood was correlated with poor health, hypochondriacal worry, and separation anxiety in childhood. These findings are consistent with a growing literature that links childhood adversity to adult hypochondriasis; they support the interpersonal model.

This paper presents the mechanisms of hypochondria from the perspective of different theoretical orientations in psychoanalysis. The authors analyze the significance of narcissism, the death instinct (mainly from the perspective of Melanie Klein's school) and the masochistic tendencies, in hypochondria. The paper presents the views of various psychoanalytical authors on the links between hypochondria and other mental disorders. The authors also present the theory and empirical data, showing the connection between somatoform disorders and the traumatic experiences in childhood. The authors stress the importance of the contribution of different theoretical schools in psychoanalysis to the understanding of the intra psychic work of hypochondria.

The authors take into account body involvement during the existential critical periods. The concept of body involvement considers both the biological (organic) involvement of the body, i.e. all the 'psychosomatic' (in a wider sense) dimensions, and the involvement of the mental representation of one's body. This involvement refers to some clinical conditions as 'abnormal somatic styles of existence', hypochondriasis and dysmorphophobia (all grouping in the DSM-IV 'somatoform disorders') and the anorexic states. From a structural psychogenetic point of view, this firm involvement of the body (naturally we are referring to the 'experienced body') is stressed in light of its importance in self identity construction and maintenance, especially when, as in some existential critical periods, identity physiologically faces significant modifications and hazardous movements., (Copyright 2000 S. Karger AG, Basel)

Cognitive and emotional outcomes were assessed after unilateral posteroventral pallidotomy (PVP) and ventral intermediate nucleus thalamotomy (Vim-Th) in patients suffering from idiopathic Parkinson's disease (PD). PVP was performed on 12 PD patients (8 men and 4 women, mean age 56.4 years, 6 left lesions and 6 right lesions) and Vim-Th was performed on 13 PD patients (5 men and 8 women, mean age 63.2 years, 6 left lesions and 7 right lesions). In both the PVP group and the Vim-Th group, the Hoehn and Yahr staging scores (p < 0.01) and the Unified Parkinson's Disease Rating Scale activities of daily living and motor scores (p < 0.001) improved significantly. No significant changes in cognitive function were observed 4 weeks after unilateral PVP or Vim-Th. PVP produced a significant decline in Hasegawa's Dementia Scale-Revised scores in immediate postoperative assessments (p < 0.05), which resolved 4 weeks after surgery. While the Minnesota Multiphasic Personality Inventory depression and social introversion scores improved significantly in the Vim-Th group (p < 0.01 and p < 0.05, respectively), the hypochondriasis and hypomania scores improved significantly in the PVP group (p < 0.01 and p < 0.05, respectively). We conclude that PVP and Vim-Th influence postoperative emotional status rather than postoperative cognitive status., (Copyright 2000 S. Karger AG, Basel)

Objective: Psychiatric illness is higher among patients with irritable bowel syndrome (IBS) who seek medical care; however, a specific psychopathology that differentiates patients with IBS from patients with other organic gastrointestinal disorders has not been found. In the study described here, we investigated the predominant psychiatric symptoms in women with IBS., Methods: The criteria of Manning et al., as modified by Thompson et al., were used to make the diagnoses of IBS. Psychiatric assessment was performed by using a structured interview in 64 women, aged 20 to 70 years, 36 with IBS and 28 with chronic cholelithiasis. Diagnosis of chronic cholelithiasis was made by histopathological examination. The final diagnoses were confirmed by interview after 1 year. The diagnostic system based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) was used to make the current diagnoses. The Present State Examination (PSE)-Index of Definition (ID) computer program (CATEGO) was used to define total psychopathology (total PSE score), current clinical severity (ID), and clusters of psychiatric symptoms., Results: No difference in the specific DSM-IV diagnostic categories was found, but there were more total depressive disorders in the IBS group. The ID and total PSE score were high among patients with IBS. Multiple logistic regression analysis showed that duration of gastrointestinal pain, and the symptoms of general anxiety, and hypochondriasis significantly predicted a diagnosis of IBS., Conclusions: Female patients with IBS are categorized into the general DSM-IV category of depressive disorder, their current psychiatric severity is high compared with that of women with chronic cholelithiasis, and patients with IBS are characterized by the psychiatric syndromes of general anxiety and hypochondriasis. The implications of these findings and areas for future research are discussed.

According to the cognitive-behavioral model, hypochondriacal individuals hold dysfunctional assumptions about illness, which may be triggered by critical incidents. In this study 1,158 participants completed measures of hypochondriacal concerns and self-esteem, and estimated the likelihood of various symptoms indicating catastrophic and minor illnesses. Participants who were more hypochondriacal believed that catastrophic outcomes were more likely than did the less hypochondriacal participants, but they did not differ in their estimates for minor illnesses. Estimates of the likelihood of catastrophic illness and self-esteem independently contributed to the prediction of hypochondriacal concerns. In this study 2,177 participants completed a measure of hypochondriacal concerns, performed a scrambled-sentences task that included either illness terms or neutral terms, and completed a state anxiety inventory. The illness terms did not trigger higher levels of anxiety in the more hypochondriacal participants; instead, these terms appeared to make the less hypochondriacal participants as anxious as their hypochondriacal counterparts.

Objective: Evaluation of psychological and social aspects of women with diagnosed genital HPV-infection., Experimental Design: A retrospective study of 40 women with a diagnosis of HPV-genital infection has been made. INTERVENTIONS AND MEASURES: A questionnaire for gathering information on social life, sexuality and emotional relationship with the partner was submitted to the patients., Results: There is a high percentage of sexual impairments after diagnosis of HPV-infection., Conclusions: HPV infections, as many genital pathologies, lead to problems with sexuality as well as hypochondriac fears.

The available data about the hypothesis that psychological conditions cause urinary incontinence are contradictory. This study was based on a group of patients undergoing urodynamic investigation to define the type of incontinence. Patients were submitted to a battery of psychological tests, including STAXI, CES-D and IBQ (in their Italian version). Patients suffering from urge incontinence showed higher degrees of inner anger and anger trait than those suffering from stress or mixed incontinence. Neither group showed signs of depression. The conviction of illness was greatest in patients suffering from stress or mixed incontinence, whereas irritability and general hypochondria prevailed in patients suffering from urge incontinence. Such patients tend to develop psychosomatic reactions that may contribute to the severity of their symptoms.

The aim of this study was to find predictors of length of time on sick-leave and the change in sick-leave as a result of intervention. Many studies of back pain show that medical and psychosocial factors covary with length of sick-leave. The results are based on the questionnaire responses of 240 patients. A stepwise multiple regression showed that the significant predictors of number of sick-days the year after intervention were the number of sick-days before the intervention and also hypochondria. Significant predictors of sick-leave change were sleep disturbance and number of sick-days before intervention. A discriminant function analysis comparing a group that had decreased its sick-leave with one that had increased its sick-leave showed 7 predictors of increased sick-leave: high risk of somatisation; many children and family members living at home; a change in tasks at work owing to pain; brothers and sisters with longstanding pain problems; frequent pain, and sleep disturbance. It is important for physiotherapists to enquire about patients' earlier sick-leave patterns in order to identify risk factors for long-term disability among patients with back pain. Some of these factors have been identified in this study.

To clarify the relationship between panic disorder and the symptoms of hypochondriasis and somatization, we evaluated these symptoms and diagnoses in patients attending an Anxiety Disorders Clinic. Structured clinical interviews, self-report measures, and symptom diaries were used to assess 21 patients with panic disorder, 23 patients with social phobia, and 22 control subjects with no psychiatric disorders. Ten of the patients with panic disorder (48%) also met DSM-IV criteria for hypochondriasis, whereas only one of the patients with social phobia and none of the healthy control subjects met the criteria for this diagnosis. None of the participants met DSM-IV criteria for somatization disorder, even though both anxiety groups reported high levels of somatic symptoms. The panic disorder group reported higher levels of fear about illness and disease conviction and endorsed more somatic symptoms than did the other groups. A higher proportion of panic disorder patients reported previously diagnosed medical conditions (48%) as compared with patients with social phobia (17%) or healthy control subjects (14%). The panic disorder patients with DSM-IV hypochondriasis obtained higher scores on measures of hypochondriacal concerns, somatization, blood-injury phobia, and general anxiety and distress than did the panic disorder patients without hypochondriasis. The results suggest a strong association between panic disorder and hypochondriasis.

Patients with low back pain without a sufficient physical cause attract labels such as "hysteria" and "hypochondriasis," often on the basis of exclusion. The concept of "abnormal illness behavior" was introduced to clarify the classification and diagnosis of these conditions, in which the behavior of the doctor plays a particularly important part. Principles of management are discussed.

A man previously imprisoned for 11 years developed unremitting and treatment-resistant monosymptomatic hypochondriacal psychosis following a period in excess of 12 months in solitary confinement. We are unaware of any other reported incidences of this disorder arising in such circumstances.

A group was studied of 20 patients with diabetes mellitus treated in the Department of Cardiology for acute myocardial infarction. The duration of diabetes mellitus in these patients was from 5 months to 6 years, and in all patients this was the first myocardial infarction. For the study of personal features of the patients with diabetes mellitus and myocardial infarction R.B. Cattell's Self-Perception Sheet, H. Gough's ACL Adjective Test, and Multi-symptomatic Diagnostic Scale MMPI-WISKAD were used. The studied showed that the group of patients with diabetes mellitus and myocardial infarction was characterized by greater intensity of depression symptoms, excessive interest in own organism and its fitness with significant manifestation of hypochondriac-hysterical features and high level of restlessness and anxiety. The results of our study revealed many common features (great similarity) in the personality of patients with diabetes mellitus and myocardial infarction and patients with only diabetes but less common features with non-diabetic patients with myocardial infarction.

The authors think that the evolutionary perspective is fundamental in family diagnosis. Therefore, they remark the value and the limits of the use of "normal" life cycle of the family as a map to evaluate the family, to assign meaning to its difficulties and to single out the possible goals of therapy. By means of a case example, the authors show how it is possible to utilize profitably the idea of life cycle, bearing in mind the cultural context of the family.

As the skin is an organ that has a primary function in tactile receptivity and reacts directly upon emotional stimuli, dermatological practice involves a psychosomatic dimension. It is, however, the high visibility of dermatoses and their easy accessibility which make the skin a direct target for behavioural problems. Furthermore, self-destructive tendencies and hypochondriacal features often express themselves through dermatological symptoms: dermatitis artefacta and skin hypochondriasis are among the specific psychocutaneous disorders discussed here. In view of the clinical interface between dermatology and psychiatry, general guidelines are formulated and specific aspects of psychotherapy, behavioural treatment and psychotropic drug treatment are discussed.

To study the psychopathological characteristics of remissions in alcoholism, 142 patients aged 32 to 45 years were examined. The anxious hypochondriac, neurasthenia-like, asthenic-depressive, anxious suspicious, anxious depressive, excitable, euphoric, apathetic, dysphoric syndromal variants are described. Correlation of the indicated syndromal variants with the other clinical characteristics of alcoholism made it possible to distinguish a favourable and relatively unfavourable type of remission, providing a possibility of differentiating between the treatment and rehabilitation measures in patients suffering from alcoholism.

Clinical and experimental psychological studies (MMPI, Eisenks's questionnaire, methods by Luria and Kraepelin, types of attitude toward disease) carried out in 157 adults and children with progressive myodystrophies and amyotrophies revealed alterations in the neuropsychic sphere in 134 patients (85%). In the structure of borderline disorders, depressive disturbances prevailed (54.5%), and the asthenic and psychopathlike symptomatology could be seen. The use of the psychopharmacological and psychotherapeutic correction promoted regression of the psychopathological symptomatology in 76% of adults and in 84% of children.

Objective: This review will focus on aspects of the postconcussion syndrome (PCS), including accompanying symptomatology, neuropsychological changes, brain imaging studies and treatment., Method: In each topic area, those research studies resulting in the most interpretable data are reported. Since there is little research in some aspects of the PCS, some studies of limited merit are described, with their limitations outlined, in lieu of not reporting any study. The section on psychopharmacology largely consists of opinions of recognized clinicians, since there is almost no research on the psychopharmacology of PCS., Results: Mild traumatic brain injury is a relatively frequent occurrence which often results in the postconcussion syndrome (PCS), consisting of complaints of irritability, fatigue, headache, difficulty concentrating, dizziness, and memory problems. Anxiety and depression are also frequently present, especially later in its course. Although the PCS has often been thought to reflect a psychological response to injury, there is considerable recent evidence to suggest that it is primarily a physiologic disturbance. For most individuals, treatment consists primarily of education of the patient and his/her family, along with supportive counseling regarding emerging problems at work or at home. A subgroup of patients, however, may require psychopharmacologic intervention., Conclusion: More research is needed in all aspects of PCS, especially its neurophysiology and pharmacologic treatment. Relationships between neurophysiological changes and behavioral and neuropsychological changes are unknown. New imaging techniques, such as single-photon emission tomography, and positron emission tomography will likely play an important role in understanding the physiology of this disorder.

The aim of these studies was the analysis of the psychological repercussions on the closest members of families of 76 gravely traumatised patients admitted into the Intensive Care Unit (ICU) of the Hospital Universitario de Rehabilitación y Traumatología "Virgen del Rocio", Sevilla (Spain). An investigation based on social information and the Clinical Analysis Questionnaire was used. The sample of family members was composed of 42 women and 34 men, with an average age of 41.3 years (SD +/- 12.8). Results showed that (a) more than 50% of the family members of gravely traumatised patients admitted into an ICU showed symptoms of depression, (b) the women scored more points in hypochondria, suicidal depression, anxious depression, low-energy depression, guilt-resentment, apathy-withdrawal, paranoia, schizophrenia, psychasthenia and psychological disadjustment, and (c) in general terms, the psychological characteristics of the families were far from the norm of the control group.