Robbins J M, Kirmayer L J
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock 72202, USA.
Psychol Med. 1996 May;26(3):575-89. doi: 10.1017/s0033291700035650.
We present a 12-month prospective study of hypochondriacal worry in primary care. Data were obtained from 546 family medicine patients at the time of a physician visit for a new illness and again 1 year later. Patients were divided into four groups based on scores on the Illness Worry Scale: non-hypochondriacal (N = 460), transient hypochondriacal (N = 34); emerging hypochondriacal (N = 21); and persistent hypochondriacal (N = 31). Persistent patients had significantly more serious medical history but no more serious current illness than those low on illness worry. Patients with persistent illness worry were more likely than others to have a diagnosis of major depression or anxiety disorder, were more likely to believe that their most important significant other would pathologize new symptoms, yet were less likely to have been encouraged to see the doctor by them. Patients who became less worried over the year reported corresponding decreases in distress, attentiveness to bodily sensations, emotional vulnerability and pathological symptom attributions. We conclude that depressive or anxiety disorders, fears of emotional instability, pathological symptom attributional styles and interpersonal vulnerability provide the best prognostic evidence for enduring illness worry.
我们对基层医疗中疑病性担忧进行了一项为期12个月的前瞻性研究。数据来自546名家庭医学患者，在他们因新病就诊时收集一次，一年后再收集一次。根据疾病担忧量表的得分，患者被分为四组：非疑病性（N = 460）、短暂疑病性（N = 34）、初发疑病性（N = 21）和持续性疑病性（N = 31）。与疾病担忧程度低的患者相比，持续性疑病性患者有明显更严重的病史，但目前病情并不更严重。患有持续性疾病担忧的患者比其他人更有可能被诊断为重度抑郁症或焦虑症，更有可能认为他们最重要的重要他人会将新症状视为病态，然而被重要他人鼓励去看医生的可能性更小。在这一年中担忧减轻的患者，其痛苦、对身体感觉的关注度、情绪易感性和病理性症状归因也相应减少。我们得出结论，抑郁或焦虑症、对情绪不稳定的恐惧、病理性症状归因方式和人际易感性为持续的疾病担忧提供了最佳的预后证据。
