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Aspects of abnormal illness behavior.

MB, ChB, MD, DPM, FRANZCP, FRCPsych, FRACP, FASSA, AM, Professor and Head, Department of Psychiatry, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia.
Indian Journal of Psychiatry 07/1993; 35(3):145-50.
Source: PubMed
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    • "Previous studies have shown that attempts to reassure patients are often ineffective [13-16]. Clinicians and textbooks may attribute unsuccessful reassurance to patients’ abnormal illness behaviour, i.e. persistence of illness behaviour despite medical reassurance [13,17-19]. However, an alternative explanation placing less blame on the patient is that ineffective reassurance may be due to the fact that patients and doctors perceive clinical encounters in different ways [20-22]. "
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    ABSTRACT: Many patients who consult their GP are worried about their health, but there is little empirical data on strategies for effective reassurance. To gain a better understanding of mechanisms for effective patient reassurance, we explored cognitions underlying patients' worries, cognitions underlying reassurance and factors supporting patients' reassuring cognitions. In a qualitative study, we conducted stimulated recall interviews with 21 patients of 12 different GPs shortly after their consultation. We selected consultations in which the GPs aimed to reassure worried patients and used their videotaped consultation as a stimulus for the interview. The interviews were analysed with thematic coding and by writing interpretive summaries. Patients expressed four different core cognitions underlying their concerns: 'I have a serious illness', 'my health problem will have adverse physical effects', 'my treatment will have adverse effects' and 'my health problem will negatively impact my life'. Patients mentioned a range of person-specific and context-specific cognitions as reasons for these core cognitions. Patients described five core reassuring cognitions: 'I trust my doctor's expertise', 'I have a trusting and supporting relationship with my doctor', 'I do not have a serious disease', 'my health problem is harmless' and 'my health problem will disappear.' Factors expressed as reasons for these reassuring cognitions were GPs' actions during the consultation as well as patients' pre-existing cognitions about their GP, the doctor-patient relationship and previous events. Patients' worrying cognitions were counterbalanced by specific reassuring cognitions, i.e. worrying and reassuring cognitions seemed to be interrelated. Patients described a wide range of worrying cognitions, some of which were not expressed during the consultation. Gaining a thorough understanding of the specific cognitions and tailoring reassuring strategies to them should be an effective way of achieving reassurance. The identified reassuring cognitions can guide doctors in applying these strategies in their daily practice.
    BMC Family Practice 04/2014; 15(1):73. DOI:10.1186/1471-2296-15-73 · 1.74 Impact Factor
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    • "Tiene 62 ítems que pueden ser contestados con un " sí " o un " no " . El instrumento se compone de 7 dimensiones que describen diferentes aspectos de la conducta anormal de enfermedad (Lojo, Hilser, Quiroz, Llor y Nieto, 1995; Pilowsky, 1993): – Hipocondría general: preocupación fóbica con respecto al propio estado de salud, asociada con un alto nivel de ansiedad y con algún grado de conciencia de lo inapropiado de esta actitud. – Convicción de enfermedad: creencia por parte del sujeto de estar seriamente enfermo de un trastorno físico hasta el punto de rechazar las palabras tranquilizadoras del médico. "
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    ABSTRACT: El objetivo de este estudio es determinar la conducta de enfermedad en las mujeres que presentan preeclampsia y su relación con la depresión. Un total de 60 mujeres embarazadas con preeclampsia y 60 mujeres con embarazo normal fueron comparadas en conducta de enfermedad y depresión en un diseño transversal. La conducta de enfermedad fue evaluada mediante la versión española del Illness Behaviour Questionaire (IBQ). La depresión fue evaluada con la versión española del CES-D. Los resultados indican que las mujeres embarazadas con preeclampsia, comparadas con las embarazadas sin preeclampsia, presentaron niveles significativamente más altos (p<0,001) en depresión y en las siguientes subescalas del IBQ: hipocondría, convicción de enfermedad, negación del problema, irritabilidad y distorsión afectiva. No se encontraron diferencias significativas en percepción psicológica versus somática de la enfermedad ni tampoco en inhibición afectiva. Los resultados sugieren que las embarazadas con preeclampsia tienen una peor conducta de enfermedad que las embarazadas sin preeclampsia.
    International Journal of Clinical and Health Psychology 01/2006; 6(1). · 2.79 Impact Factor
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