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Chronic Fatigue Syndrome: Limbic Encephalopathy in a Dysregulated Neuroimmune Network
Published in Jay A. Goldstein, Chronic Fatigue Syndromes, 2020
Hysterical disorders are not common and only two of my patients have had multiple personality disorder. Dissociative disorders or fugue states which also occur more frequently in victims of child abuse could be subsumed under temporal lobe phenomena. Hypochondriacs present much less frequently than would be expected, although they may come to the office of the CFS practitioner in their long search for help. Inquiring of these patients about temporolimbic symptoms should be done but it is rarely productive. It is not difficult for me to distinguish the patient with somatization disorder from one with CFS. Patients with somatization disorder should not have recurrent flu-like illnesses with sore throat, specific encoding problems, fibromyalgia tender points, laboratory results suggesting immune activation, or characteristic findings on brain functional imaging. The symptoms of somatization disorder must begin prior to age 30 in order to be diagnosed by DSM-III-R criteria. The average age of onset of CFS is the mid-30s. I thus find patients with somatization disorder to be rare, although the diagnosis is made frequently.
Psychosocial Assessment of GI Symptoms
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Stuart J. Eisendrath, Rafael O. Gray
Another condition similar to somatization, in terms of being unconsciously produced by the patient, is hypochondriasis. In this condition, the patient has the persistent belief that he or she has a disease; this belief is refractory to medical evaluations and reassurances by physicians. The condition often occurs in patients during their 40s or older, usually with an equal proportion of men and women. Some investigators have linked hypochondriasis to depression and recommended antidepressant-medication trials (40). Similar to patients with somatization disorder, these patients often do not recognize that any psychiatric disorder is present, so they do best when followed by one primary physician (41). This physician should adopt an attitude that is not too reassuring lest the patient feel the doctor is dismissing him; it is preferable for the physician to say that because he realizes the patient is genuinely suffering he wants to see him regularly to monitor the medical condition. As with somatization-disorder patients, hypochondriacal patients often do best with time-contingent appointments.
Managing difficult patients: Their pain and yours
Published in Marian Stuart, Joseph Lieberman, The Fifteen Minute Hour, 2018
Marian Stuart, Joseph Lieberman
Hypochondriacs suffer from anxiety and depression, particularly because they exaggerate their appraisal of disease risk, jeopardy, and vulnerability. Scheduling them for regular appointments and exploring the context of their lives along with their symptoms are effective treatment. Their suffering is acknowledged, and they are allowed to retain one or two symptoms. Chronic complainers are recognized as needing their disease, but they are encouraged to make small changes that help them feel more in control of their lives. Overt symptoms indicating stress generally involve rapid and shallow breathing, muscle tension, and racing thoughts. Stress management generally consists of deliberately taking slow, deep breaths, relaxing the muscles, and modifying thought processes. Pain syndromes can be treated with a variety of behavioral techniques.
A preliminary investigation of Cyberchondria and its correlates in a clinical sample of patients with obsessive–compulsive disorder, anxiety and depressive disorders attending a tertiary psychiatric clinic
Published in International Journal of Psychiatry in Clinical Practice, 2022
Matteo Vismara, Beatrice Benatti, Luca Ferrara, Anna Colombo, Monica Bosi, Alberto Varinelli, Luca Pellegrini, Caterina Viganò, Naomi A. Fineberg, Bernardo Dell’Osso
Only one previous investigation assessed CYB in a clinical sample of subjects with hypochondriasis (i.e., illness anxiety disorder and/or somatic symptom disorder) (Newby and McElroy 2020). In this study, the CSS total score was higher than in our sample (CSS total mean score 102.2 ± 21.4). A previous investigation conducted on orthopaedic patients reported a CSS total mean score of 60 ± 16, which is similar to the score emerged in our patients’ group (Blackburn et al. 2019). However, in this latter study, only subjects who searched on the Internet for health-related information were included, while this criterion was not followed in our study. In our sample, if only patients who used the Internet as the main source to search for health-related information are selected, the CSS total score was numerically higher (68.4 ± 19.2). Comparing our results with previous investigations, we could affirm that patients with ADs, MDD, or OCD suffer a level of CYB that is lower than patients with health anxiety or hypochondriasis, but is higher than patients with a medical concern (e.g., orthopaedic problems).
From hypochondrium to hypochondria
Published in Journal of the History of the Neurosciences, 2023
As for “hypochondriasis,” it is more difficult to define in just a few words. Moreover, it should be noted that the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has replaced this term with “illness anxiety disorder” and “somatic symptom disorder.” One recent definition among numerous others is that hypochondriasis is “a preoccupation with having a serious disease based on a misinterpretation of bodily symptoms” (Meng et al. 2019, 2).
Childhood and family factors in the development of health anxiety: A systematic review
Published in Children's Health Care, 2018
Mette Viller Thorgaard, Lisbeth Frostholm, Charlotte Ulrikka Rask
Excessive HA is a central feature of hypochondriasis but can also be present in other somatoform disorders, anxiety disorders, and mood disorders. In contrast to a dimensional view, the diagnosis of hypochondriasis represents a categorical view of HA. In the former DSM-IV (American Psychiatric Association, 1994), hypochondriasis is defined as a non-delusional preoccupation with fears of having, or the idea that one has, a serious disease based on misinterpretation of benign bodily symptoms. Additional criteria are persistence of the preoccupation despite appropriate medical evaluation and reassurance causing clinically significant distress and duration of at least 6 months. Similar diagnostic criteria are described in the ICD-10 (WHO, 1992). However, both the ICD and DSM diagnoses for hypochondriasis have been criticized for being too exclusive yet not preventing extensive diagnostic overlap with other somatoform disorders (Creed & Barsky, 2004; Fink et al., 2004; Gureje, Ustun, & Simon, 1997). In the new DSM-5 (American Psychiatric Association, 2013), hypochondriasis has been exchanged by two new diagnostic entities placed within the section of “Somatic symptom and related disorders,” that is somatic symptom disorder and illness anxiety disorder, respectively. The diagnoses share high HA as a criterion, but the presence of additional distressing somatic symptoms is also required for the former but not the latter diagnosis. A recent study showed that the majority of individuals originally diagnosed with DSM-IV hypochondriasis met the criteria for somatic symptom disorder (74%) rather than for illness anxiety disorder (26%) (Bailer et al., 2016), and the empirical evidence for this new classification is still lacking (Starcevic, 2013). It was recently critically evaluated by Rief and Martin, who concluded that pathological HA should better be classified as a unique condition distinct from other diagnoses within the category of somatic symptom and related disorders (Rief & Martin, 2014). Other researchers have suggested that hypochondriasis should be reclassified as an anxiety disorder (Olatunji, Deacon, & Abramowitz, 2009; Weck, Bleichhardt, Witthöft, & Hiller, 2011) due to the conceptual overlap with various types of anxiety disorders such as panic disorder, generalized anxiety, illness phobia, and obsessive-compulsive disorder.