Regional Centre for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark.
Psychosomatics. 2012 Jan-Feb;53(1):58-67. doi: 10.1016/j.psym.2011.05.006.
Hypochondriasis, now often designated as health anxiety, is important in terms of prevalence, levels of suffering, and health services cost in adults. Whereas the DSM-IV-TR suggests that the condition primarily begins in adulthood, retrospective reports point to a possible origin in childhood with onset as early as preschool age. However, little research has addressed health anxiety in children. In the present study we explored parental-reported health anxiety symptoms (HAS) and their association with physical and mental health in a population-based sample of 5- to 7-year-old children.
Parents of 1323 children (49.7% boys), recruited from the birth cohort: Copenhagen Child Cohort CCC 2000, completed questionnaires regarding their child's HAS, and physical and mental health. Associations were examined using multiple logistic regression analyses adjusted for concurrent chronic physical disease.
HAS were present in 17.6% and present 'a lot' (categorized as considerable HAS) in 2.4% of the children. Children with considerable HAS demonstrated more physical health problems and internalizing disorders than children with no or non-considerable HAS, but in the majority (71.9%) no associated chronic physical disease or other mental disorder was reported. In a subsample of children with functional somatic symptoms (FSS), impairing FSS were more likely among children who reported HAS.
The findings suggest that HAS present as primary complaints early in life and are associated with impairing child health problems in the area of FSS and internalizing disorders. These aspects may be important to understand and also to prevent the development of severe health anxiety.
疑病症,现在通常被指定为健康焦虑,在成年人中的患病率、痛苦程度和医疗保健成本方面都很重要。虽然 DSM-IV-TR 表明这种情况主要发生在成年期,但回顾性报告指出,它可能起源于儿童期,早在学龄前就开始出现。然而,很少有研究涉及儿童的健康焦虑。在本研究中,我们在一个基于人群的 5 至 7 岁儿童样本中,探讨了父母报告的健康焦虑症状(HAS)及其与身心健康的关系。
从出生队列哥本哈根儿童队列 CCC 2000 中招募了 1323 名儿童(49.7%为男孩)的父母,他们完成了关于孩子 HAS 以及身心健康的问卷。使用多变量逻辑回归分析调整了同时存在的慢性躯体疾病,来检查相关性。
17.6%的儿童存在 HAS,2.4%的儿童存在“大量”(归类为相当多的 HAS)。与无 HAS 或非相当 HAS 的儿童相比,具有相当多 HAS 的儿童表现出更多的身体健康问题和内化障碍,但在大多数(71.9%)情况下,没有报告与 HAS 相关的慢性躯体疾病或其他精神障碍。在有功能性躯体症状(FSS)的儿童亚组中,报告有 HAS 的儿童更有可能出现影响 FSS 的症状。
研究结果表明,HAS 作为主要的抱怨在生命早期就出现,并与 FSS 和内化障碍领域的损害儿童健康问题相关。这些方面可能对于理解和预防严重的健康焦虑的发展很重要。