Goldstein S E, Birnbom F
J Am Geriatr Soc. 1976 Apr;24(4):150-4. doi: 10.1111/j.1532-5415.1976.tb04291.x.
Hypochondriasis is poorly understood and poorly treated. Attempts to classify it have been unsatisfactory except for Pilowsky's division into primary and secondary groups. Twenty consecutive cases of hypochondriasis in elderly patients were studied; 4 were of the primary type and 16 of the secondary type. For the primary group, neither family therapy nor hospitalization was needed, and the prognosis was good. In contrast, hospitalization was always advised for the secondary group, and such patients improved while in the hospital. Psychotropic drugs, a therapeutic milieu, and often electroshock therapy were needed to treat depression. After discharge, successful treatment necessitated Day Care programs and the long-term use of family therapy. Treatment was unsuccessful in 8 patients characterized by refusal to become involved in post-discharge Day Care programs and family therapy.
疑病症鲜为人知且治疗效果不佳。除了皮洛斯基将其分为原发性和继发性两组外，对其进行分类的尝试都不尽人意。对20例老年疑病症患者进行了连续研究；其中4例为原发性，16例为继发性。对于原发性组，既不需要家庭治疗也不需要住院治疗，预后良好。相比之下，继发性组总是建议住院治疗，这类患者在住院期间病情有所改善。治疗抑郁症需要使用精神药物、治疗环境，而且常常需要电击疗法。出院后，成功的治疗需要日间护理项目和长期的家庭治疗。8例患者治疗失败，其特点是拒绝参与出院后的日间护理项目和家庭治疗。
