British Journal of Health Psychology, 12(4), November 2007, pp.511-523.
Publisher:
Wiley
... of hypochondriasis and health anxiety. Results reveal a 0.4% point prevalence rate of DSM-IV hypochondriasis. In contrast to that, 6% of the German population suffers from severe health anxiety. There are small positive effects for female gender, higher age and lower school education on health anxiety. Subjects with high health anxiety report a much lower health-related quality of life and a higher risk for a type of psychotherapeutic or psychiatric treatment. These results support the development of less restrictive criteria for hypochondriasis and place emphasis on the clinical and socio-economic relevance of health anxiety.
Epidemiologic studies on hypochondriasis are very rare and have not been included in large North American community surveys until now. In order to gain information on the prevalence as well as the socio-demographic characteristics of hypochondriasis, the following community study was carried out. Analyses are based on an assessment of 1575 subjects selected by socio-demographic representation criteria for the German community. All subjects completed the Illness Attitude Scales (IAS) and responded to several additional questions on sociodemographics and diagnostic criteria pertaining to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) hypochondriasis. The IAS is internationally one of the best-established self-rating questionnaires for the assessment of hypochondriasis and health anxiety. Results reveal a 0.4% point prevalence rate of DSM-IV hypochondriasis. In contrast to that, 6% of the German population suffers from severe health anxiety. There are small positive effects for female gender, higher age and lower school education on health anxiety. Subjects with high health anxiety report a much lower health-related quality of life and a higher risk for a type of psychotherapeutic or psychiatric treatment. These results support the development of less restrictive criteria for hypochondriasis and place emphasis on the clinical and socio-economic relevance of health anxiety.
Social Science and Medicine, 66(12), June 2008, pp.2401-2412.
Publisher:
Elsevier
The strong negative correlations observed between the sense of coherence (SOC) scale and measures of depression and anxiety raise the question of whether the SOC scale inversely measures the other constructs. The main aim of the present study was to examine the discriminant validity of the three measures by comparing their associations with health indicators and behaviours. The participants were 25 to 74-year-old Finnish men (n = 2351) and women (n = 2291) from the National Cardiovascular Risk Factor Survey conducted in 1997. The SOC scale had high inverse correlations with both depression (r = −0.62 among both men and women) and anxiety measures (r = −0.57 among the men and r = −0.54 among the women). Although confirmatory factor analyses suggested that it was possible to differentiate between SOC, cognitive depressive symptoms and anxiety, the estimated correlations were even higher than those mentioned above. Education was related only to SOC, but the associations of SOC, cognitive depressive symptoms and anxiety with self-reported and clinically measured health indicators (body mass index, blood pressure, cholesterol) and health behaviours were almost identical. The variation in the lowest SOC tertile was more strongly associated with health variables than in the highest tertile. To conclude, the size of the overlap between the SOC and depression scales was the same as between depression and anxiety measures. This indicates that future studies should examine the discriminant validity of different psychosocial scales more closely, and should compare them in health research in order
The strong negative correlations observed between the sense of coherence (SOC) scale and measures of depression and anxiety raise the question of whether the SOC scale inversely measures the other constructs. The main aim of the present study was to examine the discriminant validity of the three measures by comparing their associations with health indicators and behaviours. The participants were 25 to 74-year-old Finnish men (n = 2351) and women (n = 2291) from the National Cardiovascular Risk Factor Survey conducted in 1997. The SOC scale had high inverse correlations with both depression (r = −0.62 among both men and women) and anxiety measures (r = −0.57 among the men and r = −0.54 among the women). Although confirmatory factor analyses suggested that it was possible to differentiate between SOC, cognitive depressive symptoms and anxiety, the estimated correlations were even higher than those mentioned above. Education was related only to SOC, but the associations of SOC, cognitive depressive symptoms and anxiety with self-reported and clinically measured health indicators (body mass index, blood pressure, cholesterol) and health behaviours were almost identical. The variation in the lowest SOC tertile was more strongly associated with health variables than in the highest tertile. To conclude, the size of the overlap between the SOC and depression scales was the same as between depression and anxiety measures. This indicates that future studies should examine the discriminant validity of different psychosocial scales more closely, and should compare them in health research in order to bring parallel concepts into the same scientific discussion.
Subject terms:
mental health problems, anxiety, demographics, depression, health needs;
... conditions than those who were not abused. Women who experienced psychological/emotional abuse - alone, repeatedly, or with other types of abuse - had significantly increased odds of reporting bone or joint problems, digestive problems, depression or anxiety, chronic pain, and high blood pressure or heart problems. It is important that health care and service providers acknowledge psychological/emotional,
This American study assessed the extent of different types of abuse, repeated and multiple abuse experiences among women aged 60 and older, and their effects on the women's self-reported health. A cross-sectional study of a clinical sample of 842 community-dwelling women aged 60 and older completed a telephone survey about type and frequency of abuse, self-reported health status and health conditions, and demographic characteristics. Nearly half of the women had experienced at least one type of abuse - psychological/emotional, control, threat, physical, or sexual - since turning 55 years old. Sizable proportions were victims of repeat abuse. Many women experienced multiple types of abuse and experienced abuse often. Abused older women were significantly more likely to report more health conditions than those who were not abused. Women who experienced psychological/emotional abuse - alone, repeatedly, or with other types of abuse - had significantly increased odds of reporting bone or joint problems, digestive problems, depression or anxiety, chronic pain, and high blood pressure or heart problems. It is important that health care and service providers acknowledge psychological/emotional, control, threat, physical, and sexual abuse against older women and understand their health implications.
Subject terms:
women, anxiety, depression, elder abuse, health needs;
A summary report from the Social Policy Research Unit (SPRU) of the University of York in association with Carers UK, on distress in carers. Data from the British Household Panel Survey between 1991 and 2000 was used. The research shows that unpaid carers experience health inequalities relative to the general population. The report looks at carers' health problems, identifies which carers are most at risk, and presents figures for prevalence of carer distress before, during and after caregiving. The research was funded by the UK Department of Health.
A summary report from the Social Policy Research Unit (SPRU) of the University of York in association with Carers UK, on distress in carers. Data from the British Household Panel Survey between 1991 and 2000 was used. The research shows that unpaid carers experience health inequalities relative to the general population. The report looks at carers' health problems, identifies which carers are most at risk, and presents figures for prevalence of carer distress before, during and after caregiving. The research was funded by the UK Department of Health.
Subject terms:
informal care, stress, anxiety, carers, health needs;
International Journal of Geriatric Psychiatry, 24(4), April 2009, pp.400-408.
Publisher:
Wiley
... participants received an Axis I diagnosis (depressive, anxiety, or substance); another 17 (12.1%) were diagnosed with an adjustment disorder. Participants were more likely to recognize having a problem if they had an Axis I diagnosis, more distress on the BSI-18, family member or friend with a behavioural health problem, and greater thought suppression. In logistic regression, participants who identified
Older adults' recognition of a behavioural health (ie mental health or substance abuse) need is one of the strongest predictors of their use of behavioural health services. Thus, study aims were to examine behavioural health problems in a sample of older adults receiving home-based aging services, their recognition of behavioural health problems, and covariates of problem recognition. The study design was cross-sectional. Older adults (n = 141) receiving home-based aging services completed interviews that included: Structured Clinical Interview for DSM-IV; Brief Symptom Inventory-18; attitudinal scales of stigma, expectations regarding aging, and thought suppression; behavioural health treatment experience; and questions about recognition of behavioural health problems. Thirty (21.9%) participants received an Axis I diagnosis (depressive, anxiety, or substance); another 17 (12.1%) were diagnosed with an adjustment disorder. Participants were more likely to recognize having a problem if they had an Axis I diagnosis, more distress on the BSI-18, family member or friend with a behavioural health problem, and greater thought suppression. In logistic regression, participants who identified a family member or friend with a behavioural health problem were more likely to identify having a behavioural health problem themselves. Findings suggest that older adults receiving home-based aging services who recognize behavioural health problems are more likely to have a psychiatric diagnosis or be experiencing significant distress, and they are more familiar with behavioural health problems in others. This familiarity may facilitate treatment planning; thus, older adults with behavioural health problems who do not report familiarity of problems in others likely require additional education .
Subject terms:
home care, housebound people, older people, service uptake, anxiety, depression, health needs;
British Journal of Psychiatry, 193(10), October 2008, pp.332-337.
Publisher:
Cambridge University Press
Patients with high health anxiety were randomly assigned to brief CBT and compared with a control group Greater improvement was seen in Health Anxiety Inventory (HAI) scores (primary outcome) in patients treated with CBT (n=23) than in the control group (n=26) (P=0.001). Similar but less marked differences were found for secondary outcomes of generalised anxiety, depression and social function, and there were fewer health service consultations. The CBT intervention resulted in improvements in outcomes alongside higher costs, with an incremental cost of £33 per unit reduction in HAI score. Cognitive–behavioural therapy for health anxiety within a genitourinary medicine clinic is effective and suggests wider use of this intervention in medical settings.
Patients with high health anxiety were randomly assigned to brief CBT and compared with a control group Greater improvement was seen in Health Anxiety Inventory (HAI) scores (primary outcome) in patients treated with CBT (n=23) than in the control group (n=26) (P=0.001). Similar but less marked differences were found for secondary outcomes of generalised anxiety, depression and social function, and there were fewer health service consultations. The CBT intervention resulted in improvements in outcomes alongside higher costs, with an incremental cost of £33 per unit reduction in HAI score. Cognitive–behavioural therapy for health anxiety within a genitourinary medicine clinic is effective and suggests wider use of this intervention in medical settings.
In contrast to homeostasis, allostasis refers to the relatively new idea of "viability through change." This book addresses basic physiological regulatory systems, and examines bodily regulation under duress. It integrates the basic concepts of physiological homeostasis with disorders such as depression, stress, anxiety and addiction.
In contrast to homeostasis, allostasis refers to the relatively new idea of "viability through change." This book addresses basic physiological regulatory systems, and examines bodily regulation under duress. It integrates the basic concepts of physiological homeostasis with disorders such as depression, stress, anxiety and addiction.
Subject terms:
life style, stress, addiction, anxiety, costs, depression, health needs;
Aging and Mental Health, 11(5), September 2007, pp.596-603.
Publisher:
Taylor and Francis
This study sought to examine the influence of experiential avoidance (EA) as a moderating variable between reported physical health problems and anxiety and depression among older adults. Experiential avoidance has been found in previous studies to be strongly associated with a number of psychological disorders in younger adults but has received minimal attention in older populations. Two-hundred-and-eight individuals from New Zealand between the ages of 70 and 92 years old participated in this study. The Geriatric Anxiety Inventory, the Geriatric Depression Scale and the Acceptance and Action Questionnaire were used to measure anxiety, depression and EA, respectively. It was hypothesized that self-reported health (SRH) and EA would be associated with depression and anxiety at the zero order level. It was also hypothesized that EA would be a unique predictor of depression and anxiety and would moderate the relationships between SRH and both depression and anxiety. Multiple regression analyses indicated that EA explained 8% of the unique variance in depression, 20% in anxiety and moderated the relationships between SRH and both depression and anxiety. This study also found that the relationships involving EA were more pronounced with anxiety as compared with depression in this elderly sample. The theoretical and practical applications of these findings are discussed.
This study sought to examine the influence of experiential avoidance (EA) as a moderating variable between reported physical health problems and anxiety and depression among older adults. Experiential avoidance has been found in previous studies to be strongly associated with a number of psychological disorders in younger adults but has received minimal attention in older populations. Two-hundred-and-eight individuals from New Zealand between the ages of 70 and 92 years old participated in this study. The Geriatric Anxiety Inventory, the Geriatric Depression Scale and the Acceptance and Action Questionnaire were used to measure anxiety, depression and EA, respectively. It was hypothesized that self-reported health (SRH) and EA would be associated with depression and anxiety at the zero order level. It was also hypothesized that EA would be a unique predictor of depression and anxiety and would moderate the relationships between SRH and both depression and anxiety. Multiple regression analyses indicated that EA explained 8% of the unique variance in depression, 20% in anxiety and moderated the relationships between SRH and both depression and anxiety. This study also found that the relationships involving EA were more pronounced with anxiety as compared with depression in this elderly sample. The theoretical and practical applications of these findings are discussed.
Subject terms:
mental health problems, older people, self-concept, anxiety, depression, health needs;
British Journal of Health Psychology, 9(4), November 2004, pp.579-581.
Publisher:
Wiley
The authors aimed to describe the levels of anxiety and depression in patients during the 3 month period following the end of chemotherapy treatment and to identify factors that predict psychological morbidity. They performed a prospective study in women with ovarian cancer to determine the changes in psychological status in the 3 months following completion of chemotherapy. Sixty-three consecutive patients were assessed at the completion of chemotherapy (Time 1) and 57 at 3 months follow-up (Time 2). Relevant disease and patient characteristics were recorded and patients were assessed at Time 1 for anxiety, depression and their perception of emotional support, an index of their psychosocial environment. Anxiety and depression were re-assessed at Time 2. The results indicate significant initial psychological morbidity, with clinical caseness for anxiety (38%) and depression (33%) being common. Follow-up at Time 2 shows that patients undergo a significant reduction in cases (19%) and symptoms of depression but an increase in cases of anxiety (47%). The principal factors associated with symptoms of anxiety at Time 2 were poor perceived social support, increased intrusive thoughts
The authors aimed to describe the levels of anxiety and depression in patients during the 3 month period following the end of chemotherapy treatment and to identify factors that predict psychological morbidity. They performed a prospective study in women with ovarian cancer to determine the changes in psychological status in the 3 months following completion of chemotherapy. Sixty-three consecutive patients were assessed at the completion of chemotherapy (Time 1) and 57 at 3 months follow-up (Time 2). Relevant disease and patient characteristics were recorded and patients were assessed at Time 1 for anxiety, depression and their perception of emotional support, an index of their psychosocial environment. Anxiety and depression were re-assessed at Time 2. The results indicate significant initial psychological morbidity, with clinical caseness for anxiety (38%) and depression (33%) being common. Follow-up at Time 2 shows that patients undergo a significant reduction in cases (19%) and symptoms of depression but an increase in cases of anxiety (47%). The principal factors associated with symptoms of anxiety at Time 2 were poor perceived social support, increased intrusive thoughts and, to a lesser extent, younger age. Medical parameters, such as the stage of disease, response of the cancer to treatment, Ca125 (a tumour glycoprotein) and Karnofsky Performance status (a measure of how well the patients is) were not associated with worse psychological outcome. These data show for the first time that social support and intrusive thoughts, rather than physical parameters, are the principal determinants of psychological morbidity in patients with ovarian cancer.
Subject terms:
psychology, women, anxiety, cancer, depression, emotions, health needs;
British Journal of Health Psychology, 9(3), September 2004, pp.381-392.
Publisher:
Wiley
... or a waiting treatment group. Measures were taken prior to randomization, at the end of the treatment or waiting period, at the end of the second treatment group for that group only and at three months post-treatment for both groups. The Hospital Anxiety and Depression Scale, the Total Concerns Questionnaire, the Quality of Life after Myocardial Infarction Questionnaire, the EuroQual (subjective health significantly reduced anxiety and depression and improved quality of life of ICD patients. It is not clear if these benefits are sustained.
The effectiveness of a comprehensive 12-week CR programme for ICD patients was evaluated. All surviving and suitable ICD patients being cared for by a regional implantation centre were invited to attend a 12-week cognitive-behavioural cardiac rehabilitation programme that had been modified to meet the needs of this group. Patients assenting were randomized to either an immediate treatment or a waiting treatment group. Measures were taken prior to randomization, at the end of the treatment or waiting period, at the end of the second treatment group for that group only and at three months post-treatment for both groups. The Hospital Anxiety and Depression Scale, the Total Concerns Questionnaire, the Quality of Life after Myocardial Infarction Questionnaire, the EuroQual (subjective health rating scale), the Shuttle Test and a number of ICD shocks and ATP episodes were used in this study. For those patients willing and able to attend, the cognitive-behavioural CR programme produced significant benefits in terms of psychological and functional adaptation to living with the device. A comprehensive 12-week CR programme that incorporated both psychological and exercise-based components significantly reduced anxiety and depression and improved quality of life of ICD patients. It is not clear if these benefits are sustained.