Hypochondriacal fears and beliefs in obsessive‐compulsive disorder

118

Background: The Illness Attitude Scales (IAS) were developed by Robert Kellner as a clinimetric index for measuring hypochondriacal fears and beliefs (worry about illness, concerns about pain, health habits, hypochondriacal beliefs, thanatophobia, disease phobia, bodily preoccupations, treatment experience and effects of symptoms). The IAS have been extensively used in the past two decades, but there has been no comprehensive review of their properties and applications. Methods: A review of the literature using both computerized (Medline, PsycINFO) and manual searches was performed. Results: The IAS were found to successfully discriminate between hypochondriacal patients and control subjects, and between patients with various manifestations of illness behaviour. They showed a high test-retest reliability in normal subjects, and changed in the expected direction after treatment of hypochondriasis. The IAS were also positively related to other hypochondriasis-related measures, and yielded important information in a variety of medical and surgical settings. Their content has paved the way for the development of some of the Diagnostic Criteria for Psychosomatic Research. Conclusions: The clinimetric properties and high sensitivity of the IAS make them the gold standard for the self-rated assessment of hypochondriacal fears and beliefs.

Section: Resultsmentioning

confidence: 99%

The Illness Attitude Scales

Sirri

Grandi²,

Fava³

2008

118

“…What type of relationship do obsessive-compulsive symptoms and hypochondriasis entertain? On the basis of the type and longitudinal development of hypochondriacal fears and beliefs [37], the clinician may decide to tackle obsessive-compulsive disorder, regarding hypochondriasis as an ensuing phenomenon, or they may be considered as independent syndromes.…”

Section: Clinimetric Implications For Psychiatric Assessmentmentioning

confidence: 99%

Psychometric Theory Is an Obstacle to the Progress of Clinical Research

Fava

Ruini

Rafanelli³

2004

130

153

Psychometric theory is the basis for the development of assessment instruments in psychiatric research. However, the psychometric model appears to be largely inadequate in the clinical setting because of its lack of sensitivity to change and its quest for homogeneous components. Clinimetrics offers a viable alternative to psychometrics, both from a conceptual and a methodological viewpoint. Current diagnostic entities (DSM) are based on clinimetric principles, but their use is still influenced by psychometric models. Suggestions for switching gears in assessment research are offered.

“…However, the most interesting finding is that, although the HARS total score was not significantly different between the two groups, psychiatric patients scored significantly higher than TMJ patients on the psychic anxiety subscale, whereas TMJ patients scored significantly higher on the somatic anxiety subscale of the HARS as compared to psychiatric outpatients (table 3). This finding is quite remarkable, considering that psychiatric patients typically display a high level of hypochondriasis and somatisation [22, 23, 24, 25, 26]. Thus, while mean HARS total score indicates the presence of significant anxiety in both groups, each group seems to be characterised by a distinct pattern of anxiety symptoms, with the TMJ group showing high somatic anxiety and low psychic anxiety, and the psychiatric group displaying the opposite pattern.…”

Section: Discussionmentioning

confidence: 81%

Personality and Psychopathology in Patients with Temporomandibular Joint Pain-Dysfunction Syndrome

Meldolesi

Picardi

Accivile³

et al. 2000

Objective: Our aim was to deepen the understanding of the psychosomatic aspects of temporomandibular joint (TMJ) pain dysfunction syndrome. Patients affected by this syndrome were compared with both healthy subjects and psychiatric patients, using both self-report and physician-scored psychological measures. Methods: Three sex- and age-matched groups were recruited: a TMJ group (n = 32), a healthy group (n = 22) and a psychiatric group (n = 22). The psychiatric group consisted of outpatients diagnosed as having a DSM-IV anxiety or depressive disorder of mild to moderate severity. Psychometric assessment included the Minnesota Multiphasic Personality Inventory (MMPI) and the Hamilton Anxiety Rating Scale (HARS). Results: Psychiatric patients scored higher than both the comparison groups on all but one of the MMPI scales; the majority of the differences were significant or approached significance. TMJ patients scored higher than healthy controls on the Hs (hypochondriasis; p ≤ 0.01), Hy (hysteria; p ≤ 0.01) and D (depression; p ≤ 0.05) scales. Psychiatric patients scored higher than TMJ patients on the HARS psychic anxiety subscale (p ≤ 0.05), while TMJ patients scored higher than psychiatric patients on the somatic anxiety subscale (p ≤ 0.05). Conclusions: Certain personality characteristics were associated with TMJ dysfunction. However, further longitudinal studies should be performed to properly assess causal relationships. Despite signs of neuroticism, anxiety and depression, patients with TMJ dysfunction differed from anxious and depressed patients. While the latter displayed a higher level of psychopathology, each group was characterised by a distinct pattern of anxiety symptoms. In addition, a substantial proportion of TMJ patients had little awareness of their inner states and emotions.