Noyes R, Kathol R G, Fisher M M, Phillips B M, Suelzer M T, Woodman C L
Department of Psychiatry, University of Iowa College of Medicine, Iowa City.
Psychosomatics. 1994 Nov-Dec;35(6):533-45. doi: 10.1016/S0033-3182(94)71722-9.
To examine the diagnostic stability and outcome of hypochondriasis, the authors followed 50 patients with this disorder and 50 age- and sex-matched control subjects after 1 year. After 1 year, two-thirds of the subjects continued to meet criteria for hypochondriasis, and the remaining third had persisting hypochondriacal symptoms. The hypochondriacal subjects were improved on most measures but still differed from the control subjects with regard to attitudes, perceptions, and behaviors that had distinguished them initially. More severe symptoms, longer duration of illness, and coexisting psychiatric illness were predictive of a worse outcome. The data indicate that the diagnosis of hypochondriasis is stable over time, and that, although symptoms wax and wane, characteristic features persist. The findings underscore the importance of diagnosing and treating hypochondriasis in medical outpatients.
为研究疑病症的诊断稳定性及预后,作者对50例患有此病的患者以及50名年龄和性别匹配的对照者进行了为期1年的随访。1年后,三分之二的受试者仍符合疑病症标准,其余三分之一有持续的疑病症状。疑病受试者在大多数指标上有所改善,但在最初使其有别于对照者的态度、认知和行为方面仍与对照者存在差异。症状更严重、病程更长以及并存精神疾病预示着预后更差。数据表明疑病症的诊断随时间推移具有稳定性,并且尽管症状有起伏,但特征性表现持续存在。这些发现强调了在门诊患者中诊断和治疗疑病症的重要性。