Impact of nickel oral hyposensitization on quality of life in systemic nickel allergy syndrome.

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.

Coronavirus: A trigger for OCD and illness anxiety disorder?

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).

[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.

THE PSYCHO-PHYSIOLOGICAL STATUS IN CELIAC DISEASE.

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.

Childhood maltreatment is associated with depression but not with hypochondriasis in later life.

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.

Previous experiences with illness and traumatic experiences: a specific risk factor for hypochondriasis?

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.

[Hypochondriac symptoms in late-onset depression: the relationship between hypochondria and somatic state of patients].

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.

Diagnostic criteria for psychosomatic research and somatic symptom disorders.

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.

Anxiety and depression propensities in patients with acute toxic liver injury.

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.

Health anxiety disorders: a cognitive construal.

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.

[Clinico-psychopathological features and dynamic aspects of long-standing and chronic endogenous depressions].

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.

[Depressions in Alzheimer's disease].

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.

[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.

[Hypochondriasis as a personality pathology (to a problem of postaddictive hypochondriasis)].

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).

[Study of the emotional-and-personality sphere in patients with psoriasis concurrent with chronic opisthorchiasis].

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.

[Personality disorders and somatic diseases (the problem of hypochondrical development of personality)].

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).

Hypochondria: the worried well.

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.

[Hypochondriasis and somatisation in elderly]. / Hypocondrie et somatisations chez la personne âgée.

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.