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精神性疑病症的治疗:一例报告

Treatment of mental hypochondriasis: a case report.

作者信息

Weck Florian

机构信息

Department of Clinical Psychology and Psychotherapy, University of Frankfurt, Varrentrappstrasse 40-42, 60486, Frankfurt, Germany,

出版信息

Psychiatr Q. 2014 Mar;85(1):57-64. doi: 10.1007/s11126-013-9270-6.

Abstract

Hypochondriasis is characterized by intensive fears of serious disease. Most patients with hypochondriasis worry about physical diseases like cancer, although in rare cases, patients report severe fears of mental disorders (e.g., schizophrenia), a phenomenon described in the literature as mental hypochondriasis. However, little is known about this rare subtype of hypochondriasis and experts have questioned whether mental hypochondriasis has much in common with the type of hypochondriasis in which somatic diseases are the focus of preoccupation. This paper presents, a case report of a woman with a fear of schizophrenia, which was treated with cognitive therapy. This patient fulfills the DSM-IV criteria of hypochondriasis and exhibits many characteristics (e.g., selective attention, safety behavior) considered to be maintaining factors in well-established cognitive-behavioral models of hypochondriasis. Cognitive treatment strategies for hypochondriasis (e.g., attention training, behavioral experiments) also proved effective in this case of mental hypochondriasis.

摘要

疑病症的特点是强烈害怕患上严重疾病。大多数疑病症患者担心诸如癌症之类的身体疾病,不过在极少数情况下,患者报告称极度害怕精神障碍(如精神分裂症),这种现象在文献中被描述为精神性疑病症。然而,对于这种罕见的疑病症亚型知之甚少,而且专家们质疑精神性疑病症与以躯体疾病为关注焦点的疑病症类型是否有很多共同之处。本文呈现了一名害怕精神分裂症的女性的病例报告,该患者接受了认知疗法治疗。这名患者符合《精神疾病诊断与统计手册》第四版疑病症的标准,并展现出许多在成熟的疑病症认知行为模型中被视为维持因素的特征(如选择性注意、安全行为)。疑病症的认知治疗策略(如注意力训练、行为实验)在这例精神性疑病症中也被证明是有效的。

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