Fava G A, Grandi S, Rafanelli C, Fabbri S, Cazzaro M
Department of Psychiatry, State University of New York at Buffalo, USA.
J Clin Psychiatry. 2000 Apr;61(4):317-22; quiz 323. doi: 10.4088/jcp.v61n0414.
The aim of the study was to evaluate the effectiveness of individual explanatory therapy in hypochondriasis.
Twenty patients with DSM-IV hypochondriasis were randomly assigned to 2 groups. One received explanatory therapy and was assessed again after a 6-month follow-up. The other was first assigned to a waiting list and subsequently treated with explanatory therapy. All patients received usual medical care from their physicians. Assessments involved both observer and self-rated instruments.
In both groups, explanatory therapy was significantly associated with a reduction of hypochondriacal fears and beliefs, improvement in affective disturbances and anxiety sensitivity, and a decrease in health care utilization. Therapeutic gains were maintained at follow-up. Substantial residual symptomatology, however, remained.
The results suggest that hypochondriasis is a treatable condition and that explanatory therapy is a viable therapeutic tool. Further research should disclose the actual components of the mechanism of change in hypochondriacal patients.
本研究旨在评估个体解释性疗法对疑病症的疗效。
将20例符合《精神疾病诊断与统计手册》第四版(DSM-IV)疑病症诊断标准的患者随机分为两组。一组接受解释性疗法,并在6个月随访后再次进行评估。另一组先被列入等候名单,随后接受解释性疗法治疗。所有患者均接受医生提供的常规医疗护理。评估采用观察者评定和自评工具。
在两组中,解释性疗法均与疑病恐惧和信念的减轻、情感障碍和焦虑敏感性的改善以及医疗保健利用率的降低显著相关。治疗效果在随访中得以维持。然而,仍存在大量残余症状。
结果表明疑病症是一种可治疗的疾病,解释性疗法是一种可行的治疗工具。进一步的研究应揭示疑病患者改变机制的实际组成部分。