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BMJ Case Reports Nov 2019Somatic symptom disorder (SSD) is a diagnosis that was introduced with publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in...
Somatic symptom disorder (SSD) is a diagnosis that was introduced with publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in 2013. It eliminated the diagnoses of somatisation disorder, undifferentiated somatoform disorder, hypochondriasis and pain disorder; most of the patients who previously received these diagnoses are now diagnosed in DSM-5 with SSD. The main feature of this disorder is a patient's concern with physical symptoms for which no biological cause is found. It requires psychiatric assessment to exclude comorbid psychiatric disease. Failure to recognise this disorder may lead the unwary physician or surgeon to embark on investigations or diagnostic procedures which may result in iatrogenic complications. It also poses a significant financial burden on the healthcare service. Patients with non-specific abdominal pain have a poor symptomatic prognosis with continuing use of medical services. Proven treatments include cognitive behavioural therapy, mindfulness therapy and pharmacological treatment using selective serotonin reuptake inhibitors or tricyclic antidepressants. The authors describe the case of a 31-year-old woman with an emotionally unstable personality disorder and comorbid disease presenting to the emergency department with a 3-week history of left-sided abdominal and leg pain. Despite a plethora of investigations, no organic cause for her pain was found. She was reviewed by the multidisciplinary team including surgeons, physicians, neurologists and psychiatrists. A diagnosis of somatoform symptom disorder was subsequently rendered. As patients with SSD will present to general practice and the emergency department rather than psychiatric settings, this case provides a cautionary reminder of furthering the need for appropriate recognition of this condition.
Topics: Adult; Diagnosis, Differential; Emergency Service, Hospital; Female; Humans; Medically Unexplained Symptoms; Palliative Care; Personality Disorders; Somatoform Disorders; Suicidal Ideation
PubMed: 31772129
DOI: 10.1136/bcr-2019-231550 -
BioPsychoSocial Medicine Oct 2021Cognitive-behavioral therapy (CBT) helps individuals to eliminate avoidant and safety-seeking behaviors that prevent self-correction of faulty beliefs, thereby... (Review)
Review
Cognitive-behavioral therapy (CBT) helps individuals to eliminate avoidant and safety-seeking behaviors that prevent self-correction of faulty beliefs, thereby facilitating stress management to reduce stress-related disorders and enhance mental health. The present review evaluated the effectiveness of CBT in stressful conditions among clinical and general populations, and identified recent advances in CBT-related techniques. A search of the literature for studies conducted during 1987-2021 identified 345 articles relating to biopsychosocial medicine; 154 (45%) were review articles, including 14 systemic reviews, and 53 (15%) were clinical trials including 45 randomized controlled trials. The results of several randomized controlled trials indicated that CBT was effective for a variety of mental problems (e.g., anxiety disorder, attention deficit hypersensitivity disorder, bulimia nervosa, depression, hypochondriasis), physical conditions (e.g., chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, breast cancer), and behavioral problems (e.g., antisocial behaviors, drug abuse, gambling, overweight, smoking), at least in the short term; more follow-up observations are needed to assess the long-term effects of CBT. Mental and physical problems can likely be managed effectively with online CBT or self-help CBT using a mobile app, but these should be applied with care, considering their cost-effectiveness and applicability to a given population.
PubMed: 34602086
DOI: 10.1186/s13030-021-00219-w -
Journal of Medical Internet Research Jan 2022Social media has been extensively used for the communication of health-related information and consecutively for the potential spread of medical misinformation....
BACKGROUND
Social media has been extensively used for the communication of health-related information and consecutively for the potential spread of medical misinformation. Conventional systematic reviews have been published on this topic to identify original articles and to summarize their methodological approaches and themes. A bibliometric study could complement their findings, for instance, by evaluating the geographical distribution of the publications and determining if they were well cited and disseminated in high-impact journals.
OBJECTIVE
The aim of this study was to perform a bibliometric analysis of the current literature to discover the prevalent trends and topics related to medical misinformation on social media.
METHODS
The Web of Science Core Collection electronic database was accessed to identify relevant papers with the following search string: ALL=(misinformati* OR "wrong informati*" OR disinformati* OR "misleading informati*" OR "fake news*") AND ALL=(medic* OR illness* OR disease* OR health* OR pharma* OR drug* OR therap*) AND ALL=("social media*" OR Facebook* OR Twitter* OR Instagram* OR YouTube* OR Weibo* OR Whatsapp* OR Reddit* OR TikTok* OR WeChat*). Full records were exported to a bibliometric software, VOSviewer, to link bibliographic information with citation data. Term and keyword maps were created to illustrate recurring terms and keywords.
RESULTS
Based on an analysis of 529 papers on medical and health-related misinformation on social media, we found that the most popularly investigated social media platforms were Twitter (n=90), YouTube (n=67), and Facebook (n=57). Articles targeting these 3 platforms had higher citations per paper (>13.7) than articles covering other social media platforms (Instagram, Weibo, WhatsApp, Reddit, and WeChat; citations per paper <8.7). Moreover, social media platform-specific papers accounted for 44.1% (233/529) of all identified publications. Investigations on these platforms had different foci. Twitter-based research explored cyberchondria and hypochondriasis, YouTube-based research explored tobacco smoking, and Facebook-based research studied vaccine hesitancy related to autism. COVID-19 was a common topic investigated across all platforms. Overall, the United States contributed to half of all identified papers, and 80% of the top 10 most productive institutions were based in this country. The identified papers were mostly published in journals of the categories public environmental and occupational health, communication, health care sciences services, medical informatics, and medicine general internal, with the top journal being the Journal of Medical Internet Research.
CONCLUSIONS
There is a significant platform-specific topic preference for social media investigations on medical misinformation. With a large population of internet users from China, it may be reasonably expected that Weibo, WeChat, and TikTok (and its Chinese version Douyin) would be more investigated in future studies. Currently, these platforms present research gaps that leave their usage and information dissemination warranting further evaluation. Future studies should also include social platforms targeting non-English users to provide a wider global perspective.
Topics: Bibliometrics; COVID-19; Communication; Disinformation; Humans; SARS-CoV-2; Social Media; United States; Vaccination Hesitancy
PubMed: 34951864
DOI: 10.2196/28152 -
The Primary Care Companion For CNS... Jul 2021Side effects of selective serotonin reuptake inhibitors (SSRIs), the most commonly used antidepressants, are usually underreported in clinical trials. Systematic...
Side effects of selective serotonin reuptake inhibitors (SSRIs), the most commonly used antidepressants, are usually underreported in clinical trials. Systematic evaluation of side effects associated with SSRIs with structured instruments in a naturalistic setting is an important design to fully understand the side effect profile of various SSRIs. We examined the frequencies of the side effects induced by 3 commonly used SSRIs, sertraline, escitalopram, and fluoxetine, by using a self-rating instrument designed to measure the subjective symptoms of patients in a naturalistic treatment setting. The subjects were outpatients recruited from the psychiatry department of a tertiary care hospital. The subjects were aged ≥ 18 years; were diagnosed with depression, anxiety spectrum disorders, adjustment disorder, hypochondriasis, or impulse control disorder according to criteria; and were on SSRI monotherapy. The assessment instrument included 42 items and was devised using drug package insert data on the most commonly observed side effects of antidepressants released by the US Food and Drug Administration. A total of 100 patients participated in the study. Among them, 70% were women. The most common diagnosis was depression (49%). Of the patients, 53% were taking sertraline, 38% escitalopram, and 8% fluoxetine. The common side effects reported by patients were flatulence (64%), somnolence (59%), memory impairment (51%), decreased concentration (50%), yawning (47%), fatigue (45%), dry mouth (45%), weight gain (45%), light headedness (43%), and sweating (38%). Patients treated with escitalopram had significantly higher incidence of headache, pruritus, memory impairment, decreased concentration, and dizziness. Patients treated with sertraline had significantly decreased appetite. The study results highlight the prevalence and pattern of side effect profiles of 3 commonly used SSRIs and provide baseline data for comparison with other similar studies.
Topics: Antidepressive Agents; Citalopram; Cross-Sectional Studies; Female; Humans; Selective Serotonin Reuptake Inhibitors; Sertraline
PubMed: 34324797
DOI: 10.4088/PCC.20m02747 -
Current Psychiatry Reports Aug 2020The construct of cyberchondria was introduced relatively recently. This article aims to review the conceptualization, theoretical basis and correlates of cyberchondria,... (Review)
Review
PURPOSE OF REVIEW
The construct of cyberchondria was introduced relatively recently. This article aims to review the conceptualization, theoretical basis and correlates of cyberchondria, as well as its prevention and management.
RECENT FINDINGS
Although there is no consensus, most definitions of cyberchondria emphasize online health research associated with heightened distress or anxiety. The two theoretical models of cyberchondria involve reassurance seeking and specific metacognitive beliefs. Cyberchondria has relationships with health anxiety, problematic Internet use and symptoms of obsessive-compulsive disorder, with public health implications pertaining to functional impairment and altered healthcare utilization. Suggestions about prevention and management of cyberchondria have been put forward, but not tested yet. Research interest in cyberchondria has steadily increased. It is uncertain whether cyberchondria can be considered a distinct entity. Future research should aim to clarify the conceptual status of cyberchondria, quantify its impact and develop evidence-based approaches for a better control of cyberchondria.
Topics: Anxiety; Anxiety Disorders; Humans; Hypochondriasis; Internet; Obsessive-Compulsive Disorder; Uncertainty
PubMed: 32852626
DOI: 10.1007/s11920-020-01179-8 -
Gut and Liver May 2022Following acute gastroenteritis (AGE) due to bacteria, viruses, or protozoa, a subset of patients develop new onset Rome criteria positive irritable bowel syndrome... (Review)
Review
Following acute gastroenteritis (AGE) due to bacteria, viruses, or protozoa, a subset of patients develop new onset Rome criteria positive irritable bowel syndrome (IBS), called postinfection IBS (PI-IBS). The pooled prevalence of PI-IBS following AGE was 11.5%. PI-IBS is the best natural model that suggests that a subset of patients with IBS may have an organic basis. Several factors are associated with a greater risk of development of PI-IBS following AGE including female sex, younger age, smoking, severity of AGE, abdominal pain, bleeding per rectum, treatment with antibiotics, anxiety, depression, somatization, neuroticism, recent adverse life events, hypochondriasis, extroversion, negative illness beliefs, history of stress, sleep disturbance, and family history of functional gastrointestinal disorders (FGIDs), currently called disorder of gut-brain interaction. Most patients with PI-IBS present with either diarrhea-predominant IBS or the mixed subtype of IBS, and overlap with other FGIDs, such as functional dyspepsia is common. The drugs used to treat non-constipation IBS may also be useful in PI-IBS treatment. Since randomized controlled trials on the efficacy of drugs to treat PI-IBS are rare, more studies are needed on this issue.
Topics: Dyspepsia; Female; Gastroenteritis; Gastrointestinal Diseases; Humans; Irritable Bowel Syndrome; Risk Factors
PubMed: 34789582
DOI: 10.5009/gnl210208 -
Northern Clinics of Istanbul 2022No studies of thyroid-related hormone levels have been conducted in patients with hypochondriasis to date. The aim of this study is to examine thyroid-related hormones...
OBJECTIVE
No studies of thyroid-related hormone levels have been conducted in patients with hypochondriasis to date. The aim of this study is to examine thyroid-related hormones in patients with hypochondriasis.
METHODS
Sixty patients with hypochondriasis and 138 healthy controls were included in this study. Patients with hypochondriasis who applied to the psychiatry outpatient clinic and met the study criteria and healthy controls were determined by chart analysis.
RESULTS
According to the results of the comparisons, TSH, fT3, and fT4 levels did not show a statistically significant difference between hypochondriasis patients and healthy controls.
CONCLUSION
Thyroid hormone levels are not associated with hypochondriasis.
PubMed: 36447579
DOI: 10.14744/nci.2022.67365 -
Advances in Psychosomatic Medicine 2012The term illness behavior was introduced by Mechanic and Volkart to describe the individuals' different ways to respond to their own health status. Pilowsky's concept of... (Review)
Review
The term illness behavior was introduced by Mechanic and Volkart to describe the individuals' different ways to respond to their own health status. Pilowsky's concept of abnormal illness behavior encompasses several clinical conditions characterized by a maladaptive mode of experiencing, perceiving, evaluating and responding to one's own health status. The concept of somatization was criticized because it implies the presence of psychological distress or an underlying psychiatric disturbance when an organic cause for somatic symptoms is not found. Thus, more atheoretical terms , such as functional somatic symptoms and medically unexplained symptoms, were introduced. Both Kellner's Symptom Questionnaire and Derogatis' Symptom Checklist-90 include a scale for somatic symptoms, and other questionnaires were specifically designed to measure their frequency and severity. Kellner's Illness Attitude Scales appear to be the gold standard for the measurement of the hypochondriacal spectrum, which includes several clinical conditions, such as nosophobia, thanatophobia and health anxiety. The assessment of illness denial should consider that a certain degree of denial may sometimes prevent patients from overwhelming psychological distress resulting from life-threatening or stigmatized diseases. Denial may concern both physical and psychiatric symptoms. Specific instruments are available for both types of denial. The cognitive and emotional representations developed by subjects when they have to cope with an illness or a perceived health threat are subsumed under the concept of illness perception and may be assessed by the Brief Illness Perception Questionnaire.
Topics: Adaptation, Psychological; Attitude to Health; Awareness; Denial, Psychological; Humans; Hypochondriasis; Illness Behavior; Mental Disorders; Personality Assessment; Personality Inventory; Psychophysiologic Disorders; Somatoform Disorders
PubMed: 22056904
DOI: 10.1159/000330015 -
Journal of Anxiety Disorders Mar 2024Cyberchondria (i.e., excessive health-related Internet search linked to psychological distress) is usually associated with health anxiety, but relationships with other...
Cyberchondria (i.e., excessive health-related Internet search linked to psychological distress) is usually associated with health anxiety, but relationships with other psychopathological symptoms were also found. However, studies are lacking in patients with hypochondriasis, and it remains unclear whether cyberchondria and its subfacets are specific to hypochondriasis (i.e., higher levels in hypochondriasis compared to other mental disorders). Patients with hypochondriasis (N = 50), a clinical (N = 70), and a healthy comparison group (N = 51) completed two questionnaires on cyberchondria whose combined 17 subscales were reduced to three relevant cyberchondria subfacets by second-order factor analysis. The cyberchondria subfacet emotional distress/negative consequences linked to health-related Internet searches showed significantly higher scores in patients with hypochondriasis than in the two comparison groups (d ≥ 1.7) and was the only predictor of dimensional health anxiety (β = .58, p ≤ .001). The two subfacets type/extent of health-related Internet searches and characteristics of the Internet (e.g., attitude toward unreliability, vast amounts of information) were less specifically associated with hypochondriasis. The results are consistent with models of cyberchondria and hypochondriasis, particularly on the anxiety-reinforcing vicious circle and maintaining factors. Based on the findings, practical implications are discussed.
Topics: Humans; Hypochondriasis; Anxiety; Anxiety Disorders; Surveys and Questionnaires; Health Status
PubMed: 38128287
DOI: 10.1016/j.janxdis.2023.102798