Mabe P A, Riley W T, Jones L R, Hobson D P
Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta 30912-3800, USA.
Int J Psychiatry Med. 1996;26(4):443-59. doi: 10.2190/Y2E1-LAMH-JMDE-3MXX.
This study examines the effects of two medical contexts on the relationship of hypochondriacal traits and their potential correlates.
Correlates of hypochondriacal traits were compared from a matched sample of fifty-five general medical inpatients with a sample of fifty-five medical inpatients referred for psychiatric evaluation. Patients completed questionnaires assessing emotional distress and health attitudes, beliefs, and behaviors, and their attending physician completed ratings of the patient's illness and illness behavior.
Patients referred for psychiatric consultation exhibited significantly higher levels of hypochondriacal illness presentation than the matched nonreferred sample. Moderated regression analyses revealed three trends regarding the interactive effects of group status on the relationship of hypochondriacal traits to their potential correlates: 1) presence of angry feelings and interpersonal friction was positively associated with hypochondriacal concerns for the psychiatric referred patients only, 2) the tendency to deny life stresses and attribute all problems to the effects of illness was positively associated with a misinterpretation of the severity of their illness and hypochondriacal illness presentation for the psychiatric referred patients, whereas this association was negative for the nonreferred medical patients, and 3) the association of reports of emotional distress symptoms with hypochondriacal illness preparation was negative for the psychiatric referred patients and positive for the nonreferred medical patients.
Study results suggest that hypochondriasis may not represent a uniform nosological disorder and that the context of its study can significantly influence etiologic findings.
本研究考察了两种医疗环境对疑病特质及其潜在相关因素之间关系的影响。
从55名普通内科住院患者的匹配样本与55名转介进行精神科评估的内科住院患者样本中，比较疑病特质的相关因素。患者完成评估情绪困扰以及健康态度、信念和行为的问卷，其主治医生对患者的疾病和患病行为进行评分。
转介进行精神科会诊的患者比匹配的未转介样本表现出显著更高水平的疑病性疾病表现。调节回归分析揭示了关于组状态对疑病特质与其潜在相关因素关系的交互作用的三个趋势：（1）愤怒情绪和人际摩擦的存在仅与转介精神科的患者的疑病性担忧呈正相关；（2）否认生活压力并将所有问题归因于疾病影响的倾向与转介精神科的患者对其疾病严重程度的错误解读和疑病性疾病表现呈正相关，而这种关联对未转介的内科患者为负相关；（3）情绪困扰症状报告与疑病性疾病准备的关联对转介精神科的患者为负相关，对未转介的内科患者为正相关。
研究结果表明，疑病症可能并不代表一种统一的疾病分类障碍，其研究背景会显著影响病因学研究结果。
