[Acute and chronic psychoses with cenestopathies and/or hypochondriacal symptoms]. / Psicosis agudas y crónicas con cenestopatías y/o síntomas hipocondríacos.

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.

Cross-cultural adaptation of the Cyberchondria Severity Scale for Brazilian Portuguese.

INTRODUCTION: The internet has proven to be a valuable resource for self-care, allowing access to information and promoting interaction between professionals, caregivers, users of health care services and people interested in health information. However, recurring searches are often related to excessive health anxiety and a phenomenon known as cyberchondria can have impacts on physical and mental health. Within this background, a Cyberchondria Severity Scale has been developed to differentiate healthy and unhealthy behavior in internet searches for health information, based on the following criteria: compulsion, distress, excesses, and trust and distrust of health professionals. OBJECTIVE: To conduct cross-cultural adaptation of the Cyberchondria Severity Scale for Brazilian Portuguese, because of the lack of an appropriate instrument for Brazil. METHODS: This study was authorized by the original author of the scale. The process was divided into the following four steps: 1) initial translation, 2) back-translation, 3) development of a synthesized version, and 4) experimental application. RESULTS: Translation into Brazilian Portuguese required some idiomatic expressions to be adapted. In some cases, words were not literally translated from English into Portuguese. Only items 7, 8, 12, 23 and 27 were altered, as a means of both conforming to proper grammar conventions and achieving easy comprehension. The items were rewritten without loss of the original content. CONCLUSION: This paper presents a translated version of the Cyberchondria Severity Scale that has been semantically adapted for the Brazilian population, providing a basis for future studies in this area, which should in turn contribute to improved understanding of the cyberchondria phenomenon in this population.

Cross-cultural adaptation of the Cyberchondria Severity Scale for Brazilian Portuguese / Tradução e adaptação transcultural da Cyberchondria Severity Scale para o português brasileiro

Abstract Introduction: The internet has proven to be a valuable resource for self-care, allowing access to information and promoting interaction between professionals, caregivers, users of health care services and people interested in health information. However, recurring searches are often related to excessive health anxiety and a phenomenon known as cyberchondria can have impacts on physical and mental health. Within this background, a Cyberchondria Severity Scale has been developed to differentiate healthy and unhealthy behavior in internet searches for health information, based on the following criteria: compulsion, distress, excesses, and trust and distrust of health professionals. Objective: To conduct cross-cultural adaptation of the Cyberchondria Severity Scale for Brazilian Portuguese, because of the lack of an appropriate instrument for Brazil. Methods: This study was authorized by the original author of the scale. The process was divided into the following four steps: 1) initial translation, 2) back-translation, 3) development of a synthesized version, and 4) experimental application. Results: Translation into Brazilian Portuguese required some idiomatic expressions to be adapted. In some cases, words were not literally translated from English into Portuguese. Only items 7, 8, 12, 23 and 27 were altered, as a means of both conforming to proper grammar conventions and achieving easy comprehension. The items were rewritten without loss of the original content. Conclusion: This paper presents a translated version of the Cyberchondria Severity Scale that has been semantically adapted for the Brazilian population, providing a basis for future studies in this area, which should in turn contribute to improved understanding of the cyberchondria phenomenon in this population.

Resumo Introdução: A internet tem se revelado um recurso valioso para o autocuidado, permitindo o acesso a informações e promovendo a interação entre profissionais, cuidadores, usuários de serviços de saúde e pessoas interessadas em informações sobre saúde. No entanto, pesquisas recorrentes na internet estão frequentemente relacionadas a ansiedade excessiva com saúde, e um fenômeno conhecido como cybercondria pode ocasionar danos à saúde física e mental do indivíduo. Nesse contexto, a Cyberchondria Severity Scale foi desenvolvida para diferenciar o comportamento saudável do não saudável no que diz respeito a pesquisas na internet sobre informações de saúde, com base nos seguintes critérios: compulsão, aflição, excessos e confiança/desconfiança nos profissionais de saúde. Objetivo: Realizar a adaptação transcultural da Cyberchondria Severity Scale para o português brasileiro, em razão da falta de um instrumento adequado para uso no Brasil. Métodos: Este estudo foi autorizado pelo autor original da escala. O processo foi dividido em quatro etapas: 1) tradução inicial, 2) retrotradução, 3) desenvolvimento de uma versão sintética, e 4) aplicação experimental. Resultados: A adaptação para o português do Brasil exigiu algumas correções em expressões idiomáticas. Em alguns casos, as palavras não foram literalmente traduzidas do inglês para o português. Apenas os itens 7, 8, 12, 23 e 27 foram alterados, com o objetivo de seguir as normas gramaticais e favorecer a compreensão. Os itens foram reescritos sem que houvesse perda do conteúdo original. Conclusões: Este trabalho apresenta uma versão traduzida da Cyberchondria Severity Scale que foi adaptada semanticamente para a população brasileira, proporcionando uma base para futuros estudos na área, o que deverá, por sua vez, contribuir para uma melhor compreensão do fenômeno cybercondria nessa população.

Hypochondriasis: considerations for ICD-11.

The World Health Organization (WHO) is currently revisiting the ICD. In the 10th version of the ICD, approved in 1990, hypochondriacal symptoms are described in the context of both the primary condition hypochondriacal disorder and as secondary symptoms within a range of other mental disorders. Expansion of the research base since 1990 makes a critical evaluation and revision of both the definition and classification of hypochondriacal disorder timely. This article addresses the considerations reviewed by members of the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders in their proposal for the description and classification of hypochondriasis. The proposed revision emphasizes the phenomenological overlap with both anxiety disorders (e.g., fear, hypervigilance to bodily symptoms, and avoidance) and obsessive-compulsive and related disorders (e.g., preoccupation and repetitive behaviors) and the distinction from the somatoform disorders (presence of somatic symptom is not a critical characteristic). This revision aims to improve clinical utility by enabling better recognition and treatment of patients with hypochondriasis within the broad range of global health care settings.

Hypochondriasis: considerations for ICD-11

The World Health Organization (WHO) is currently revisiting the ICD. In the 10th version of the ICD, approved in 1990, hypochondriacal symptoms are described in the context of both the primary condition hypochondriacal disorder and as secondary symptoms within a range of other mental disorders. Expansion of the research base since 1990 makes a critical evaluation and revision of both the definition and classification of hypochondriacal disorder timely. This article addresses the considerations reviewed by members of the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders in their proposal for the description and classification of hypochondriasis. The proposed revision emphasizes the phenomenological overlap with both anxiety disorders (e.g., fear, hypervigilance to bodily symptoms, and avoidance) and obsessive-compulsive and related disorders (e.g., preoccupation and repetitive behaviors) and the distinction from the somatoform disorders (presence of somatic symptom is not a critical characteristic). This revision aims to improve clinical utility by enabling better recognition and treatment of patients with hypochondriasis within the broad range of global health care settings.

Psychiatric disorders in burning mouth syndrome.

BACKGROUND: Prevalence of psychiatric disorders in burning mouth syndrome (BMS) is high, but their role in the pathogenesis of BMS remains unclear. OBJECTIVE: The authors aimed to assess the frequency of psychiatric disorders and the severity of psychopathology in BMS. METHODS: Thirty BMS patients and thirty-one controls underwent a psychiatric evaluation which included a structured interview (MINI-Plus) and five psychometric scales. A Visual Analogue Scale (VAS) was used to measure the intensity of burning sensation. RESULTS: Patients with BMS showed a higher frequency of current major depressive disorder, past major depressive disorder, generalized anxiety disorder, hypochondria and cancerophobia (p<0.05). In BMS patients, generalized anxiety disorder was significantly associated with current major depression and social phobia (p<0.05). As expected, cancerophobia was significantly associated with hypochondria (p<0.05). Patients with BMS had higher scores in Hamilton Rating Scale for Depression (HRSD), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Dutch Fatigue Scale (DUFS) (p<0.05). CONCLUSION: BMS patients may have a particular psychological and/or psychiatric profile. Psychometric scales might be useful in screening psychiatric disorders, as well as for assessment of treatment outcomes. In the presence of clinical relevant psychiatric symptoms, patients must be treated appropriately.

[Hypochondria, between belief and certainty]. / Hipocondría, entre creencia y certitud.

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.

[Hypochondriacal delusions in paraphrenias: a historiographical and clinical review]. / Acerca del delirio hipocondríaco en las Parafrenias: una revisión historiográfica y clínica.

Hypochondriacal delusions may eventually appear in chronic psychosis. Some authors have proposed the existence of a chronic delusional disease named Hypochondriacal Paraphrenia in which these delusions constitute its main feature. In the present article we discuss the nosological validity of the Hypochondriacal Paraphrenia and its independence from other subtypes of Paraphrenias. With this aim, an historical review of the position of the hypochondriacal symptomatology was performed form the original definitions of Lasègue and Griesinger to the description of the Hypochondriacal Paraphrenia by Karl Leonhard. Then, three cases of patients with the diagnosis of Hypochondriacal Paraphrenia are presented. We conclude that the Hypochondriacal Paraphrenia is a valid and useful nosological construct.

Acerca del delirio hipocondríaco en las Parafrenias: una revisión historiográfica y clínica / Hypochondriacal delusions in paraphrenias: a historiographical and clinical review

Las ideas delirantes hipocondríacas constituyen un síntoma de eventual aparición en las psicosis crónicas. Algunos autores han planteado la existencia de un cuadro delirante crónico, la Parafrenia Hipocondríaca, en el que este tipo de ideación delirante constituye el síntoma cardinal. En el presente trabajo se evalúa la validez nosológica de la Parafrenia Hipocondríaca y su independencia de las demás formas de Parafrenias. Para esto, se realizó una revisión histórica de la posición de la sintomatología delirante hipocondríaca desde las definiciones originales de Laségue y Griesinger hasta la descripción de la Parafrenia Hipocondríaca por Karl Leonhard. Se presentan tres casos de pacientes con el diagnóstico de Parafrenia Hipocondríaca. Concluimos que la Parafrenia Hipocondríaca representa un constructo teórico válido y útil en la discriminación de los diferentes estados delirantes crónicos.(AU)

Hypochondriacal delusions may eventually appear in chronic psychosis. Some authors have proposed the existence of a chronic delusional disease named Hypochondriacal Paraphrenia in which these delusions constitute its main feature. In the present article we discuss the nosological validity of the Hypochondriacal Paraphrenia and its independence from other subtypes of Paraphrenias. With this aim, an historical review of the position of the hypochondriacal symptomatology was performed form the original definitions of Lasegue and Griesinger to the description of the Hypochondriacal Paraphrenia by Karl Leonhard. Then, three cases of patients with the diagnosis of Hypochondriacal Paraphrenia are presented. We conclude that the Hypochondriacal Paraphrenia is a valid and useful nosological construct.(AU)

Acerca del delirio hipocondríaco en las Parafrenias: una revisión historiográfica y clínica / Hypochondriacal delusions in paraphrenias: a historiographical and clinical review

Las ideas delirantes hipocondríacas constituyen un síntoma de eventual aparición en las psicosis crónicas. Algunos autores han planteado la existencia de un cuadro delirante crónico, la Parafrenia Hipocondríaca, en el que este tipo de ideación delirante constituye el síntoma cardinal. En el presente trabajo se evalúa la validez nosológica de la Parafrenia Hipocondríaca y su independencia de las demás formas de Parafrenias. Para esto, se realizó una revisión histórica de la posición de la sintomatología delirante hipocondríaca desde las definiciones originales de Laségue y Griesinger hasta la descripción de la Parafrenia Hipocondríaca por Karl Leonhard. Se presentan tres casos de pacientes con el diagnóstico de Parafrenia Hipocondríaca. Concluimos que la Parafrenia Hipocondríaca representa un constructo teórico válido y útil en la discriminación de los diferentes estados delirantes crónicos.

Hypochondriacal delusions may eventually appear in chronic psychosis. Some authors have proposed the existence of a chronic delusional disease named Hypochondriacal Paraphrenia in which these delusions constitute its main feature. In the present article we discuss the nosological validity of the Hypochondriacal Paraphrenia and its independence from other subtypes of Paraphrenias. With this aim, an historical review of the position of the hypochondriacal symptomatology was performed form the original definitions of Lasegue and Griesinger to the description of the Hypochondriacal Paraphrenia by Karl Leonhard. Then, three cases of patients with the diagnosis of Hypochondriacal Paraphrenia are presented. We conclude that the Hypochondriacal Paraphrenia is a valid and useful nosological construct.

Transtorno de pânico e hipocondria / Panic disorder and hypocondriasis

A hipocondria é associada a diversos transtornos de ansiedade, sobretudo ao transtorno de pânico (TP). Estima-se que 50 porcento a 70 porcento dos pacientes com TP tenham sintomas hipocondríacos e que 13 porcento a 17 porcento dos hipocondríacos tenham TP associado. Considera-se que há co-morbidade com hipocondria no TP quando as preocupações com saúde não se restringem aos sintomas das crises de pânico. Relatamos um caso de uma paciente que, durante seu acompanhamento, evoluiu com hipocondria e transtorno de pânico associado. Discutimos as manifestações psiquiátricas manifestadas pela paciente, assim como analisamos aspectos conceituais, diagnósticos e prognósticos.

Hypocondriasis is associated with several anxiety disorders, including panic disorder. The available estimates of panic disorder patients with identified hypochondriacal symptoms are 50% to 70%. Complimentary, 13% to 17% of hypochondriac patients were associated with panic disorder. Comorbidity and hypocondriasis occur when health care issues are not delimited by panic disorder symptoms. We reported a patient that, during the follow-up-period, has evolved to an associated hypocondriasis and panic disorder scenario. The psychiatric symptoms were properly addressed and discussed, as well the associated conceptual aspects, diagnoses and prognosis.

Hipocondria: características e manejo. Uma revisäo / Hypochondriasis: clinical features and treatment. A review

A hipocondria é uma doença de difícil diagnóstico, principalmente pelo pouco conhecimento que se tem a seu respito. O artigo discute suas carcterísticas a partir de uma revisäo da literatura, buscando abranger seus aspectos clínicos, epidemiológicos e seu manejo

[Organic somatoform disorder. Case report]. / Transtorno somatoforme de causa orgânica. Relato de caso.

Based on the neuropsychological and imagenological evaluation of a frontal damaged patient with a somatoform disorder, we study the differential diagnosis of this condition compared to that of other patients: temporal or parietal damaged ones, schizophrenics, melancholics, obsessives, hypochondriacs and dismorphophobics.

Transtorno somatoforme de causa orgânica: relato de caso / Organic somatoform disorder: case report

Realizamos estudo a respeito do diagnóstico diferencial de um doente somatoforme apresentando sinais neuropsicológicos de natureza frontal, visando distingui-lo dos hipocondríacos e dismorfofóbicos obsessivos, bem como dos esquizofrênicos, melancólicos e lesionados cerebrais parietais e temporais.

Diagnóstico e tratamento dos transtornos somatomorfos / Diagnosis and treatment of somatoform disorders

Tratar de pacientes com transtornos Somatomorfos é um desafio para o clínico, acarretando inúmeras frustracöes: estäo sempre insatisfeitos com os atendimentos recebidos, discordando dos diagnósticos e das terapias fornecidas. Seus sintomas säo ambíguos, frequentemente näo respondem a nenhum tratamento e näo possuem sofisticaçäo psicológica . As síndromes somatomorfas estäo entre as entidades mais caras da medicina: estuds indicam que geram custos com cuidados de saúde que säo pelo menos 6 a 14 vezes maiores que os custos com saúde ocasionados por grupo-controle. Faremos breve revisäo do diagnóstico e o tratamento dos principais Transtornos Somatomorfos: 1) Transtorno de Somatizaçäo, 2) Transtorno Doloroso Somatomorfo Persistente, 3) Transtorno Hipocondríaco e 4) Transtorno Dismórfico Corporal. É vital que o médico conheça profundamente a personalidade do paciente somatomorfo e evite intervençöes desnecessárias. O encaminhamento para o psiquiatra muitas vezes näo é possível pois o paciente näo entende o seu problema como um transtorno mental. Frequentemente o treinamento do clínico geral é a única opçäo existente

"Quejas" somáticas debidas a patología psiquiatrica / Somatic complaints due to psychiatric pathology

La somatización es un trastorno en el cual el paciente se presenta en la consulta a través de "quejas somáticas" que no tienen sustrato orgánico y en el que se piensa que los factores psicológicos juegan un papel relevante. La preocupación e investigación en torno al tema han ido en aumento dadas las evidencias que muestra la elevada frecuencia del trastorno (una de cada cuatro consultas médicas), a lo que deben agregarse los altos costos personales, sociales y de los servicios de salud que aquellos conllevan. El presente artículo está dirigido a los médicos generales y especialistas no psiquiatras que son quienes reciben y asisten a estos pacientes. Desarrolla los conceptos psiquiátricos básicos sobre las somatizaciones y los trastornos psiquiátricos que las determinan, brindando los conocimientos necesarios para un adecuado abordaje y manejo desde su práctica médica general, y lograr así minimizar la alta morbimortalidad del trastono

Quejas somáticas debidas a patología psiquiatrica / Somatic complaints due to psychiatric pathology

La somatización es un trastorno en el cual el paciente se presenta en la consulta a través de quejas somáticas que no tienen sustrato orgánico y en el que se piensa que los factores psicológicos juegan un papel relevante. La preocupación e investigación en torno al tema han ido en aumento dadas las evidencias que muestra la elevada frecuencia del trastorno (una de cada cuatro consultas médicas), a lo que deben agregarse los altos costos personales, sociales y de los servicios de salud que aquellos conllevan. El presente artículo está dirigido a los médicos generales y especialistas no psiquiatras que son quienes reciben y asisten a estos pacientes. Desarrolla los conceptos psiquiátricos básicos sobre las somatizaciones y los trastornos psiquiátricos que las determinan, brindando los conocimientos necesarios para un adecuado abordaje y manejo desde su práctica médica general, y lograr así minimizar la alta morbimortalidad del trastono(AU)

Neurovegetative dystonia--psychiatric evaluation of 40 patients diagnosed by general physicians in Brazil.

The diagnosis of neurovegetative dystonia (NVD) is commonly made by general physicians in Brazil, but its precise meaning is unclear. Anecdotal evidence suggests that it is used to describe patients with a wide range of psychological and physical symptoms and is often used pejoratively, in a similar way to "crocks" in the USA. Forty patients who had been diagnosed as having NVD by general physicians working in a triage department of a general public hospital were compared with 40 non-NVD patients, matched for age and gender, from the same department. Patients were evaluated by a psychiatrist who was blind to the diagnosis that had been made. The assessment included a structured sociodemographic questionnaire, the Clinical Interview Schedule (CIS), and a routine psychiatric interview using DSM-III-R criteria. Using the CIS, the "reported symptoms" that most distinguished NVD patients from controls were somatic and anxiety, whereas for "manifest abnormality" NVD patients displayed more anxiety, histrionic behavior, hypochondriasis, and depressive thoughts. A total of 92.5% of NVD patients received diagnoses using DSM-III-R criteria compared to 37.5% of controls. The relative risk of NVD patients subsequently receiving a psychiatric disorder was 8.3 (95% CI = 2.5-43.1, p < 0.001). Although general physicians correctly identify most patients with psychiatric disorder they miss many others. Furthermore, they use an obsolete diagnostic category which has no psychiatric currency. Medical students and residents need better psychiatric training so that they can correctly identify patients in general medical settings who are suffering from mental disorders and make a diagnosis using accepted psychiatric terminology.

Perfil de personalidad al MMPI en anorexia nerviosa y bulimia nerviosa / Personality profile MMPI in anorexia nervosa and bulimia nervosa

El objetivo del presente estudio se relaciona con la controversia respecto de la existencia de un perfil de personalidad típico en los pacientes con Anorexia Nerviosa y Bulimia Nerviosa y si existe un perfil diferencial entre ambos grupos. Se utilizó el MMPI (inventario Multifásico de Personalidad de Minnesota), para determinar las características de personalidad. La muestra estaba constituída por 60 pacientes mujeres, 30 anorécticas y 30 bulímicas, con un rango de edad entre 16 y 37 años, diagnosticados de acuerdo a los criterios del DSM IV.Las pacientes con Anorexia Nerviosa obtuvieron un aumento en las escalas de Depresión, Desviación Psicótica, Paranoia y Esquizofrenia. Las pacientes con Bulimia Nerviosa obtuvieron puntajes sobre el promedio en las escalas de Hipocondriasis, Depresión, Histería, Desviación Psicopática, Paranoia, Psicastenia y Esquizofrenia. Los resultados obtenidos permitieron realizar un perfil de personalidad diferencial para cada grupo