hypochondria

Introduction

Brief introduction Hypochondriasis, also known as hypochondriacalneurosis, mainly refers to the persistent preoccupation concept of patients with this disease who are worried or believe that they have one or more serious physical diseases. The patient complains of physical symptoms and repeatedly seeks medical treatment, although repeated Negative medical examinations and doctors' explanations do not have evidence of the corresponding disease and do not dispel the patient's concerns, often accompanied by anxiety or depression. Concerns about physical malformations or preoccupation are also the disease. This disease is rare. The age of onset is 40 years for men and 50 years for women. The elderly are not rare. basic knowledge The proportion of illness: 1.5% Susceptible people: men are mostly around 40 years old, and women are mostly around 50 years old. Mode of infection: non-infectious Complications: depression, anxiety

Cause

Cause of suspected illness

Psychosocial factors (30%):

Such as the change of marriage, the separation of children, the reduction of friends, the loneliness, the stability of life are affected, the lack of security, can be the cause of the disease, some patients are iatrogenic, doctors inappropriate words, attitudes and The behavior causes the patient's suspiciousness, or the doctor makes the diagnosis inaccurate, and repeatedly makes the patient do some examination, which causes the patient to have the belief that there is a certain disease. Some patients, after the physical illness, suspect through self-suggestion or association. disease.

Quality factor (20%):

Susceptibility is also an important basis for the disease. It has been found that the disease has similar seizures in the same family members. The personality characteristics of such patients are sensitive, suspicious, subjective, stubborn, cautious, and excessive attention to the body, requiring very ten-year-old male patients. There is often forced personality before the illness, and women are related to the character of snoring.

Prevention

Suspected prevention

1. The diagnosis of suspected diseases must be very careful, and should not be confused. There are three reasons: First, the suspected disease is a functional neurosis, and the patient must be carefully and objectively examined on the basis of excluding organic diseases. In order to diagnose the disease, rash diagnosis, organic disease misdiagnosed as a functional disease, will delay the disease, endanger the patient's health, and second, many patients have aversion to the diagnosis of suspected diseases, often suspected illness and illness Equivalent, leading to distrust of doctors, which is not conducive to psychotherapy.

2. For patients diagnosed with suspected diseases, psychotherapy should be combined with other comprehensive measures to effectively promote their recovery and eliminate the concept of suspected diseases. Among them, improve the cognitive level of patients and master the four principles of confronting suspected diseases. It is a crucial psychological treatment:

(1) Do not read books and other medical materials related to medical health. This is an important principle of psychological treatment of suspected diseases.

(2) Change the habit of going to hospital for medical treatment, unless you have a certain disease, you will receive the necessary medical treatment.

(3) Eliminating the self-examination, self-examination, self-introduction of bad habits, unfounded fears, is itself a bad psychological factor, and is the trigger for a variety of physical and mental illnesses.

(4) As long as it is not an organic disease, it is necessary to hold a "listen to" attitude to all functional symptoms and discomforts on your body.

3. The suspected illness requires medical treatment. Drug treatment can eliminate the symptoms of physical and mental discomfort, enhance the patient's self-confidence, accelerate the recovery time, and many patients can recover under the psychological treatment and drug cooperation.

Complication

Suspected complications Complications depression anxiety

Often accompanied by anxiety, anxiety, fear and autonomic dysfunction symptoms, the length of the disease varies, the elderly can be prolonged for several months or years, the prognosis is poor, the onset is acute, there are obvious incentives and timely treatment, the prognosis is better The prognosis of acute onset patients is quite good, such as depression and anxiety syndrome with suspected symptoms, or on the basis of other diseases, the prognosis is good, and the general course of disease is more than 2 years, which often evolves into chronic prolongation, prognosis and The following factors are related, there are obvious mental factors, patients with confidence, hard-working, good prognosis, people with suspected personality, easy to be chronic, lack of confidence, the prognosis is not good.

Symptom

Suspected symptoms common symptoms prone to compulsive... psychotic panic attacks physical deformity disorder depression obsessive-compulsive disorder

(1) Preoccupied concept of suspected disease. The patient insists that he or she has one or several serious physical illnesses. The patient cares about his or her own illness and concerns too much about his or her physical feelings. But it has not reached the level of absurdity and delusion.

(2) Dissatisfied body complaints. Under the control of the concept of the disease, the patient makes a suspected explanation for the physiological phenomena and abnormal feelings that usually appear, and shows the corresponding physical symptoms. The complaint or symptom may be limited to a certain part, organ or system, or may involve the whole body. Symptoms of different patients have various manifestations. Some patients have very specific symptoms, and the symptoms described are vivid and realistic, showing a clear localization. Some patients have unclear disease, the nature is vague, it is difficult to say, only know that they are physically weak and have a bad state. Some patients have doubts about the deformation of the body or preoccupation, thinking that a part of their body (nose, face, eyes or female breasts, etc.) is deformed or ugly. The patient is therefore repeatedly seeking medical treatment and doing various medical examinations or operations. Although the results of various tests are negative, the interpretation and assurance of different doctors cannot dispel their doubts. It is easy to see conflicts between patients and doctors.

(3) Mental pain or social dysfunction. Patients are often accompanied by symptoms of anxiety or depression. The patient's level of worry about physical illness is not commensurate with his actual health. The patient's social function impairment due to suspected symptoms varies greatly. Pain is also the most common symptom of this disease. More than half of the patients complain of pain. The common parts are the head, waist and chest, sometimes feeling body pain. Followed by physical symptoms, can involve many different organs, such as nausea, difficulty swallowing, acid reflux, flatulence, palpitations.

Examine

Examination of suspected illness

Taking the primary suspected symptoms as the main clinical feature, the patient is overly worried about his or her health status, and has a suspicious explanation for the abnormal feeling or physiological phenomenon that occurs, has a strong concept of doubt, repeatedly seek medical treatment, and does not accept medical explanation. It is reasonable to say that the disease is more than 6 months, and the disease can be diagnosed. If the suspected disease starts after other diseases, it should be considered as a secondary suspect.

Diagnosis

Diagnosis of suspected disease

The diagnostic criteria are as follows:

1. Meet the diagnostic criteria for neurosis.

2. Taking the suspected symptoms as the main clinical image, showing at least one of the following:

(1) Worried about physical health or illness, the serious procedure is not commensurate with the actual health.

(2) A suspected explanation for the physiological phenomena and abnormal feelings that usually occur.

(3) A strong concept of suspected illness, lacking sufficient evidence, but not delusion.

3. Repeated medical treatment or repeated medical examinations, but the negative results of the examination or the doctor's reasonable explanation can not dispel concerns.

4. Exclusion of obsessive-compulsive disorder, depression, paranoid psychosis, etc., suspected symptoms are not limited to panic attacks.

Differential diagnosis

Symptoms of symptoms can be found in other mental illnesses, so they should be identified with the following diseases:

1. Depression is most often accompanied by suspected symptoms. For example, there are some biological symptoms such as early onset insomnia, circadian rhythm changes, weight loss, and mental activity. Hysteresis, symptoms such as self-crime and self-blame can be identified. Occult depression should be specially distinguished from suspected symptoms. Concealed depression masks the essence of depression with physical symptoms, but often it can be significantly treated by antidepressant treatment. The efficacy, but the suspected condition is more difficult.

2. There are symptoms of schizophrenia in the early stage, but the content is mostly bizarre, not fixed, there are thinking disorders and common hallucinations and delusions, patients are not actively seeking treatment, can be identified.

3. Other neurological disorders such as anxiety, neurasthenia and depressive neurosis can have suspected symptoms, but these suspected symptoms are secondary, while suspected neuropathy is suspected of being primary or The first symptom, the order in which the symptoms occur, combined with the clinical features, is not difficult to identify.

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