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A brief case-finding questionnaire for common mental disorders: the CMDQ.

https://arctichealth.org/en/permalink/ahliterature9248
Source
Fam Pract. 2005 Aug;22(4):448-57
Publication Type
Article
Date
Aug-2005
Author
Kaj Sparle Christensen
Per Fink
Tomas Toft
Lisbeth Frostholm
Eva Ornbøl
Frede Olesen
Author Affiliation
The Research Unit for General Practice, University of Aarhus, Denmark. kasc@alm.au.dk
Source
Fam Pract. 2005 Aug;22(4):448-57
Date
Aug-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cross-Sectional Studies
Denmark
Family Practice
Female
Humans
Male
Mental Disorders - classification - diagnosis
Middle Aged
Questionnaires
Research Support, Non-U.S. Gov't
Abstract
OBJECTIVES: The aim of the study was to validate a new case-finding instrument for common mental disorders (CMDQ). METHODS: A cross-sectional, stratified, two-phase study was carried out in 28 general practices in Aarhus County, Denmark. 1785 consecutive patients, 18-65 years old, consulting 38 GPs with a new health problem participated. Patients were screened before consultation using a one-page screening questionnaire including subscales for somatisation (SCL-SOM and Whiteley-7), anxiety (SCL-ANX4), depression (SCL-DEP6) and alcohol abuse (CAGE). A stratified subsample of 701 patients was interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) interview. We tested the external validity of the scales using the SCAN interview as gold standard. All data were analysed using appropriate weighted procedures to control for the two-phase sampling design and non-response bias. RESULTS: Estimates of sensitivity and specificity for relevant ICD-10 diagnoses at theoretical optimal cut-off points on subscales: Depressive disorder: 78/86 (SCL-DEP6); Alcohol abuse or dependence: 78/97 (CAGE); Severe anxiety disorder: 77/85 (SCL-ANX4); Somatisation disorder: 83/56 (SCL-SOM); and 75/52 (Whiteley-7); any mental disorder: 72/72 (SCL-8). At the theoretical optimal cut-off points the CMDQ demonstrated higher diagnostic accuracy than GPs on any diagnosis evaluated. CONCLUSION: The study results suggest that the CMDQ has excellent external validity for use as a diagnostic aid in primary care settings.
PubMed ID
15814580 View in PubMed
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Diagnosis of somatisation: effect of an educational intervention in a cluster randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature71134
Source
Br J Gen Pract. 2003 Dec;53(497):917-22
Publication Type
Article
Date
Dec-2003
Author
Marianne Rosendal
Flemming Bro
Per Fink
Kaj Sparle Christensen
Frede Olesen
Author Affiliation
Quality Improvement Committee for General Practice in Vejle County, and Research Unit and Institute for General Practice, Aarhus University, Aarhus, Denmark. m.rosendal@dadlnet.dk
Source
Br J Gen Pract. 2003 Dec;53(497):917-22
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Adult
Clinical Competence
Education, Medical, Continuing - methods
Family Practice - education
Female
Humans
Male
Middle Aged
Primary Health Care
Research Support, Non-U.S. Gov't
Somatoform Disorders - diagnosis
Abstract
BACKGROUND: Somatisation is highly prevalent in primary care (present in 25% of visiting patients) but often goes unrecognised. Non-recognition may lead to ineffective treatment, risk of iatrogenic harm, and excessive use of healthcare services. AIM: To examine the effect of training on diagnosis of somatisation in routine clinical practice by general practitioners (GPs). DESIGN OF STUDY: Cluster randomised controlled trial, with practices as the randomisation unit. SETTING: Twenty-seven general practices (with a total of 43 GPs) in Vejle County, Denmark. METHOD: Intervention consisted of a multifaceted training programme (the TERM [The Extended Reattribution and Management] model). Patients were enrolled consecutively over a period of 13 working days. Psychiatric morbidity was assessed by means of a screening questionnaire. GPs categorised their diagnoses in another questionnaire. The primary outcome was GP diagnosis of somatisation and agreement with the screening questionnaire. RESULTS: GPs diagnosed somatisation less frequently than had previously been observed, but there was substantial variation between GPs. The difference between groups in the number of diagnoses of somatisation failed to reach the 5% significance (P = 0.094). However, the rate of diagnoses of medically unexplained physical symptoms was twice as high in the intervention group as in the control group (7.7% and 3.9%, respectively, P = 0.007). Examination of the agreement between GPs' diagnoses and the screening questionnaire revealed no significant difference between groups. CONCLUSION: Brief training increased GPs' awareness of medically unexplained physical symptoms. Diagnostic accuracy according to a screening questionnaire remained unaffected but was difficult to evaluate, as there is no agreement on a gold standard for somatisation in general practice.
Notes
Comment In: Br J Gen Pract. 2003 Dec;53(497):914-514960212
Comment In: Br J Gen Pract. 2004 Mar;54(500):215; author reply 215-615143771
PubMed ID
14960214 View in PubMed
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The FIP study: a randomised, controlled trial of screening and recognition of psychiatric disorders.

https://arctichealth.org/en/permalink/ahliterature9595
Source
Br J Gen Pract. 2003 Oct;53(495):758-63
Publication Type
Article
Date
Oct-2003
Author
Kaj Sparle Christensen
Tomas Toft
Lisbeth Frostholm
Eva Ørnbol
Per Fink
Frede Olesen
Author Affiliation
Research Unit for Functional Disorders, Aarhus University Hospital, Research Unit for General Practice, Aarhus University. kspar@akh.aaa.dk
Source
Br J Gen Pract. 2003 Oct;53(495):758-63
Date
Oct-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Denmark
Family Practice
Female
Humans
Male
Mass Screening - methods
Mental Disorders - diagnosis
Middle Aged
Prognosis
Questionnaires - standards
Research Support, Non-U.S. Gov't
Abstract
BACKGROUND: Research on questionnaires as screening tools for psychiatric disorders has yielded conflicting results. AIM: To examine the effect of a routinely administered questionnaire on recognition of common psychiatric disorders in general practice. DESIGN OF STUDY: Randomised controlled trial. SETTING: Twenty-eight general practices in Aarhus County, Denmark. METHOD: Thirty-eight general practitioners (GPs) and 1785 consecutive patients, aged 18-65 years old, presenting with a new health problem, participated. Before consultation, patients were screened using a brief screening questionnaire (SQ) including somatisation, anxiety, depression, and alcohol abuse scales. Patients were randomised to one of two groups: 900 questionnaires were disclosed and scored by the GPs, 885 were blinded. A stratified subsample of 701 patients was interviewed after the consultation using a standardised psychiatric research interview (SCAN). RESULTS: Overall the GPs' recognition rates were 14% (95% confidence interval [CI] = -2 to 30) better for depression and 35% (95% CI = 2 to 68) better for alcohol problems when SQs were disclosed. Recognition rates for anxiety improved 8% (95% CI = -9 to 26) overall. In the case of somatoform disorders, disclosure showed no effect overall. Among those with high SQ scores, however, disclosure increased recognition rates on any mental disorder evaluated. CONCLUSION: This study demonstrated limited usefulness for routine screening for common psychiatric disorders. However, findings suggest that the SQ may be useful for case-finding among a subgroup of patients with high SQ scores.
PubMed ID
14601350 View in PubMed
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Follow-up on mental illness in medical inpatients: health care use and self-rated health and physical fitness.

https://arctichealth.org/en/permalink/ahliterature45797
Source
Psychosomatics. 2004 Jul-Aug;45(4):302-10
Publication Type
Article
Author
Morten Steen Hansen
Per Fink
Morten Frydenberg
Author Affiliation
Department of Psychiatric Demography, Psychiatric Hospital, Aarhus, Denmark. brixhansen@mail.stofanet.dk
Source
Psychosomatics. 2004 Jul-Aug;45(4):302-10
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Denmark
Female
Follow-Up Studies
Health status
Hospitalization - statistics & numerical data
Humans
Inpatients - psychology
Internal Medicine
Interview, Psychological
Male
Mental Disorders - therapy
Middle Aged
Odds Ratio
Outcome Assessment (Health Care) - statistics & numerical data
Physical Fitness - physiology - psychology
Research Support, Non-U.S. Gov't
Self Assessment (Psychology)
Abstract
Consecutively admitted internal medical inpatients (N=294) who were psychiatrically assessed with the Schedules for Clinical Assessment in Neuropsychiatry in a two-phase design were followed up in a review of public files on their use of medical care over 18 months. Self-rated outcome was assessed from health and fitness ratings at admission and after 1 year. ICD-10 mental disorders had a statistically significant impact on the risk (odds ratio) of high use (above the 80th percentile) of primary care, as did ICD-10 anxiety/depression, and worry about illness (as assessed by the Whiteley-7 Scale). The authors found a less-than-significant tendency for mental illness to influence the use of inpatient admissions and self-rated outcome.
PubMed ID
15232044 View in PubMed
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Mental disorders in primary care: prevalence and co-morbidity among disorders. results from the functional illness in primary care (FIP) study.

https://arctichealth.org/en/permalink/ahliterature9135
Source
Psychol Med. 2005 Aug;35(8):1175-84
Publication Type
Article
Date
Aug-2005
Author
Tomas Toft
Per Fink
Eva Oernboel
Kaj Christensen
Lisbeth Frostholm
Frede Olesen
Author Affiliation
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark. tomas.toft@ouh.fyns-amt.dk
Source
Psychol Med. 2005 Aug;35(8):1175-84
Date
Aug-2005
Language
English
Publication Type
Article
Keywords
Adult
Alcoholism - diagnosis - epidemiology
Anxiety Disorders - diagnosis - epidemiology
Comorbidity
Female
Humans
Hypochondriasis - diagnosis - epidemiology
International Classification of Diseases
Male
Mental Disorders - diagnosis - epidemiology
Prevalence
Primary Health Care
Research Support, Non-U.S. Gov't
Somatoform Disorders - diagnosis - epidemiology
Abstract
BACKGROUND: Prevalence and co-occurrence of mental disorders is high among patients consulting their family general practitioner (GP) for a new health problem, but data on diagnostics and socio-demographics are sketchy. METHOD: A cross-sectional two-phase epidemiological study. A total of 1785 consecutive patients with new complaints, aged 18-65 years, consulting 28 family practices during March-April 2000 in Aarhus County, Denmark were screened, in the waiting room, for mental and somatic symptoms with SCL-8 and SCL-Somatization questionnaires, for illness worry with Whitely-7 and for alcohol dependency with CAGE. In a stratified random sample of 701 patients, physician interviewers established ICD-10 diagnoses using the SCAN interview. Prevalence was calculated using weighted logistic regression, thus correcting for sample skewness. RESULTS: Half of the patients fulfilled criteria for an ICD-10 mental disorders and a third of these for more than one group of disorders. Women had higher prevalence of somatization disorder and overall mental disorders than men. Men had higher prevalence of alcohol abuse and hypochondriasis than women. Psychiatric morbidity tended to increase with age. Prevalence of somatoform disorders was 35.9% (95% CI 30.4-41.9), anxiety disorders 164% (95% CI 12.7-20.9), mood disorders 13.5% (95% CI 11.1-16.3), organic mental disorders 3.1% (95% CI 1.6-5.7) and alcohol abuse 2.2% (95% CI 1.5-3.1). Co-morbidities between these groups were highest for anxiety disorders, where 89% also had another mental diagnosis, and lowest for somatoform disorders with 39%. CONCLUSIONS: ICD-10 mental disorders are very prevalent in primary care and there is a high co-occurrence between most disorders. Somatoform disorders, however, more often than not exist without other mental disorders.
PubMed ID
16116943 View in PubMed
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Mindfulness therapy for somatization disorder and functional somatic syndromes: analysis of economic consequences alongside a randomized trial.

https://arctichealth.org/en/permalink/ahliterature117683
Source
J Psychosom Res. 2013 Jan;74(1):41-8
Publication Type
Article
Date
Jan-2013
Author
Lone Overby Fjorback
Tina Carstensen
Mikkel Arendt
Eva Ornbøl
Harald Walach
Emma Rehfeld
Per Fink
Author Affiliation
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark. lonefjor@rm.dk
Source
J Psychosom Res. 2013 Jan;74(1):41-8
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Adult
Awareness
Cognitive Therapy - economics - methods
Cohort Studies
Cost-Benefit Analysis
Denmark
Disability Evaluation
Feasibility Studies
Female
Follow-Up Studies
Health Care Costs - statistics & numerical data
Health Status Indicators
Humans
Male
Meditation - methods - psychology
Middle Aged
Pensions
Psychotherapy, Brief - economics - methods
Relaxation Therapy - economics - methods - psychology
Social Security - economics
Somatoform Disorders - diagnosis - economics - psychology - therapy
Syndrome
Treatment Outcome
Abstract
The objective of the present study is to estimate the economic consequences of somatization disorder and functional somatic syndromes such as fibromyalgia and chronic fatigue syndrome, defined as bodily distress syndrome (BDS), when mindfulness therapy is compared with enhanced treatment as usual.
A total of 119 BDS patients were randomized to mindfulness therapy or enhanced treatment as usual and compared with 5950 matched controls. Register data were analyzed from 10years before their inclusion to 15-month follow-up. The main outcome measures were disability pension at the 15-month follow-up and a reduction in total health care costs. Unemployment and sickness benefit prior to inclusion were tested as possible risk factors.
At 15-month follow-up, 25% from the mindfulness therapy group received disability pension compared with 45% from the specialized treatment group (p=.025). The total health care utilization was reduced over time in both groups from the year before inclusion (mean $5325, median $2971) to the year after inclusion (mean $3644, median $1593) (p=.0001). This overall decline was seen in spite of elevated costs due to assessment and mindfulness therapy or enhanced treatment as usual. The BDS patients accumulated significantly more weeks of unemployment and sickness benefit 5 and 10years before inclusion (p
PubMed ID
23272987 View in PubMed
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Mindfulness therapy for somatization disorder and functional somatic syndromes: randomized trial with one-year follow-up.

https://arctichealth.org/en/permalink/ahliterature117684
Source
J Psychosom Res. 2013 Jan;74(1):31-40
Publication Type
Article
Date
Jan-2013
Author
Lone Overby Fjorback
Mikkel Arendt
Eva Ornbøl
Harald Walach
Emma Rehfeld
Andreas Schröder
Per Fink
Author Affiliation
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark. lonefjor@rm.dk
Source
J Psychosom Res. 2013 Jan;74(1):31-40
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Adult
Anxiety Disorders - diagnosis - psychology - therapy
Awareness
Cognitive Therapy - methods
Comorbidity
Denmark
Depressive Disorder - diagnosis - psychology - therapy
Feasibility Studies
Female
Follow-Up Studies
Health Status Indicators
Humans
Illness Behavior
Male
Meditation - methods - psychology
Middle Aged
Psychotherapy, Brief - methods
Quality of Life - psychology
Relaxation Therapy - methods - psychology
Somatoform Disorders - diagnosis - psychology - therapy
Syndrome
Treatment Outcome
Abstract
To conduct a feasibility and efficacy trial of mindfulness therapy in somatization disorder and functional somatic syndromes such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome, defined as bodily distress syndrome (BDS).
We randomized 119 patients to either mindfulness therapy (mindfulness-based stress reduction and some cognitive behavioral therapy elements for BDS) or to enhanced treatment as usual (2-hour specialist medical care and brief cognitive behavioral therapy for BDS). The primary outcome measure was change in physical health (SF-36 Physical Component Summary) from baseline to 15-month follow-up.
The study is negative as we could not demonstrate a different development over time for the two groups (F(3,2674)=1.51, P=.21). However, in the mindfulness therapy group, improvement was obtained toward the end of treatment and it remained present at the 15-month follow-up, whereas the enhanced treatment as usual group achieved no significant change until 15-month follow-up. The change scores averaged half a standard deviation which amounts to a clinically significant change, 29% changed more than 1 standard deviation. Significant between-group differences were observed at treatment cessation.
Mindfulness therapy is a feasible and acceptable treatment. The study showed that mindfulness therapy was comparable to enhanced treatment as usual in improving quality of life and symptoms. Nevertheless, considering the more rapid improvement following mindfulness, mindfulness therapy may be a potentially useful intervention in BDS patients. Clinically important changes that seem to be comparable to a CBT treatment approach were obtained. Further research is needed to replicate or even expand these findings.
PubMed ID
23272986 View in PubMed
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A new, empirically established hypochondriasis diagnosis.

https://arctichealth.org/en/permalink/ahliterature9404
Source
Am J Psychiatry. 2004 Sep;161(9):1680-91
Publication Type
Article
Date
Sep-2004
Author
Per Fink
Eva Ørnbøl
Tomas Toft
Kaj Christensen Sparle
Lisbeth Frostholm
Frede Olesen
Author Affiliation
Research Unit for Functional Disorders, Aarhus University Hospital, DK-8000 Aarhus C, Denmark. flip@akh.aaa.dk
Source
Am J Psychiatry. 2004 Sep;161(9):1680-91
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Adult
Alcoholism - diagnosis - epidemiology
Anxiety Disorders - diagnosis - epidemiology
Comorbidity
Denmark - epidemiology
Depressive Disorder - diagnosis - epidemiology
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Hypochondriasis - classification - diagnosis - psychology
Male
Mass Screening - methods
Personality Inventory
Primary Health Care - methods
Psychiatric Status Rating Scales - statistics & numerical data
Psychometrics
Reproducibility of Results
Research Support, Non-U.S. Gov't
Severity of Illness Index
Somatoform Disorders - classification - diagnosis - epidemiology
Terminology
Abstract
OBJECTIVE: The narrow ICD-10 and DSM-IV definition of hypochondriasis makes it rarely used yet does not prevent extensive diagnosis overlap. This study identified a distinct hypochondriasis symptom cluster and defined diagnostic criteria. METHOD: Consecutive patients (N=1,785) consulting primary care physicians for new illness were screened for somatization, anxiety, depression, and alcohol abuse. A stratified subgroup of 701 patients were interviewed with the Schedules for Clinical Assessment in Neuropsychiatry and questions addressing common hypochondriasis symptoms. Symptom patterns were analyzed by latent class analysis. RESULTS: Patients fell into three classes based on six symptoms: preoccupation with the idea of harboring an illness or with bodily function, rumination about illness, suggestibility, unrealistic fear of infection, fascination with medical information, and fear of prescribed medication. All symptoms, particularly rumination, were frequent in one of the classes. Classification allowed definition of new diagnostic criteria for hypochondriasis and division of the cases into "mild" and "severe." The weighted prevalence of severe cases was 9.5% versus 5.8% for DSM-IV hypochondriasis. Compared with DSM-IV hypochondriasis, this approach produced less overlap with other somatoform disorders, similar overlap with nonsomatoform psychiatric disorders, and similar assessments by primary care physicians. Severe cases of the new hypochondriasis lasted 2 or more years in 54.3% of the subjects and 1 month or less in 27.2%. CONCLUSIONS: These results suggest that rumination about illness plus at least one of five other symptoms form a distinct diagnostic entity performing better than the current DSM-IV hypochondriasis diagnosis. However, these criteria are preliminary, awaiting cross-validation in other subject groups.
PubMed ID
15337660 View in PubMed
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A new questionnaire to identify bodily distress in primary care: The 'BDS checklist'.

https://arctichealth.org/en/permalink/ahliterature266872
Source
J Psychosom Res. 2015 Jun;78(6):536-45
Publication Type
Article
Date
Jun-2015
Author
Anna Budtz-Lilly
Per Fink
Eva Ørnbøl
Mogens Vestergaard
Grete Moth
Kaj Sparle Christensen
Marianne Rosendal
Source
J Psychosom Res. 2015 Jun;78(6):536-45
Date
Jun-2015
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular System
Checklist
Cross-Sectional Studies
Denmark
Factor Analysis, Statistical
Female
Gastrointestinal Tract
General Practice - methods - standards
Humans
Male
Middle Aged
Musculoskeletal System
Primary Health Care - methods - standards
Psychometrics
Questionnaires - standards
Reproducibility of Results
Respiratory System
Syndrome
Abstract
Functional symptoms and disorders are common in primary care. Bodily distress syndrome (BDS) is a newly proposed clinical diagnosis for functional disorders. The BDS diagnosis is based on empirical research, and the symptoms stated in the BDS criteria have been translated into a self-report questionnaire called the BDS checklist. The aim of the present study was to investigate the psychometric properties of the checklist and to test the construct of BDS.
The 30-item BDS checklist was completed by 2480 adult primary care patients in a cross-sectional study on contact and disease patterns in Danish general practice. We performed (internal) validation analyses of the collected checklist data. We also performed factor and latent class analyses to identify both BDS symptom groups and BDS patient groups.
Internal validation analyses revealed acceptable and usable psychometric properties of the BDS checklist. The factor analyses identified the four distinct determining factors for BDS: cardiopulmonary, gastrointestinal, musculoskeletal and general symptoms. Results from factor and multi-trait analyses suggested a shortening of the BDS checklist (from 30 to 25 items). The latent class analyses resulted in three severity levels (no, moderate and severe BDS); the best fit index was found for a threshold of =4 symptoms in a symptom group.
The results provide empirical support for the previously described construct of BDS with four symptom groups and three patient groups. The BDS checklist is a self-report instrument that may be used for case finding in both clinical practice and in research.
PubMed ID
25818346 View in PubMed
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The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health.

https://arctichealth.org/en/permalink/ahliterature144591
Source
PLoS One. 2010;5(3):e9873
Publication Type
Article
Date
2010
Author
Per Fink
Eva Ørnbøl
Kaj Sparle Christensen
Author Affiliation
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark. aarhus.ffl@rm.dk
Source
PLoS One. 2010;5(3):e9873
Date
2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anxiety
Denmark
Female
Follow-Up Studies
Health Care Costs
Health status
Humans
Hypochondriasis - psychology
Male
Middle Aged
Primary Health Care - economics - organization & administration
Time Factors
Abstract
Hypochondriasis is prevalent in primary care, but the diagnosis is hampered by its stigmatizing label and lack of valid diagnostic criteria. Recently, new empirically established criteria for Health anxiety were introduced. Little is known about Health anxiety's impact on longitudinal outcome, and this study aimed to examine impact on self-rated health and health care costs.
1785 consecutive primary care patients aged 18-65 consulting their family physicians (FPs) for a new illness were followed-up for two years. A stratified subsample of 701 patients was assessed by the Schedules for Clinical Assessment in Neuropsychiatry interview. Patients with mild (N = 21) and severe Health anxiety (N = 81) and Hypochondriasis according to the DSM-IV (N = 59) were compared with a comparison group of patients who had a well-defined medical condition according to their FPs and a low score on the screening questionnaire (N = 968). Self-rated health was measured by questionnaire at index and at three, 12, and 24 months, and health care use was extracted from patient registers. Compared with the 968 patients with well-defined medical conditions, the 81 severe Health anxiety patients and the 59 DSM-IV Hypochondriasis patients continued during follow-up to manifest significantly more Health anxiety (Whiteley-7 scale). They also continued to have significantly worse self-rated functioning related to physical and mental health (component scores of the SF-36). The severe Health anxiety patients used about 41-78% more health care per year in total, both during the 3 years preceding inclusion and during follow-up, whereas the DSM-IV Hypochondriasis patients did not have statistically significantly higher total use. A poor outcome of Health anxiety was not explained by comorbid depression, anxiety disorder or well-defined medical condition. Patients with mild Health anxiety did not have a worse outcome on physical health and incurred significantly less health care costs than the group of patients with a well-defined medical condition.
Severe Health anxiety was found to be a disturbing and persistent condition. It is costly for the health care system and must be taken seriously, i.e. diagnosed and treated. This study supports the validity of recently introduced new criteria for Health anxiety.
Notes
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PubMed ID
20352043 View in PubMed
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23 records – page 1 of 3.