Using Fear and Anxiety Related to COVID-19 to Predict Cyberchondria: Cross-sectional Survey Study.

BACKGROUND: Studies have highlighted that fear and anxiety generated by COVID-19 are important psychological factors that affect all populations. There currently remains a lack of research on specific amplification factors regarding fear and anxiety in the context of the COVID-19 pandemic. Despite established associations between anxiety sensitivity, intolerance of uncertainty, and cyberchondria, empirical data investigating the associations between these three variables, particularly in the context of the COVID-19 pandemic, are currently lacking. Urgent research is needed to better understand the role of repeated media consumption concerning COVID-19 in amplifying fear and anxiety related to COVID-19. OBJECTIVE: This study investigated the associations between fear of COVID-19, COVID-19 anxiety, and cyberchondria. METHODS: Convenience sampling was used to recruit respondents to participate in an online survey. The survey, which was distributed via social media and academic forums, comprised the Cyberchondria Severity Scale, Fear of COVID-19 Scale, Coronavirus Anxiety Scale, Anxiety Sensitivity Index, and Intolerance of Uncertainty Scale. Multiple mediation analyses were conducted using structural equation modeling. RESULTS: A total of 694 respondents (males: n=343, females: n=351) completed the online survey. The results showed that fear and anxiety generated by COVID-19 predicted cyberchondria (fear: ß=.39, SE 0.04, P<.001, t=11.16, 95% CI 0.31-0.45; anxiety: ß=.25, SE 0.03, P<.001, t=7.67, 95% CI 0.19-0.32). In addition, intolerance of uncertainty and anxiety sensitivity mediated the relationship between fear and anxiety generated by COVID-19 with cyberchondria. In a reciprocal model, the standardized total effects of cyberchondria on fear of COVID-19 (ß=.45, SE 0.04, P<.001, t=15.31, 95% CI 0.39-0.51) and COVID-19 anxiety (ß=.36, SE 0.03, P<.001, t=11.29, 95% CI 0.30-0.41) were statistically significant, with moderate effect sizes. Compared to males, females obtained significantly higher scores for cyberchondria (t1,692=-2.85, P=.004, Cohen d=0.22), COVID-19 anxiety (t1,692=-3.32, P<.001, Cohen d=0.26), and anxiety sensitivity (t1,692=-3.69, P<.001, Cohen d=0.29). CONCLUSIONS: The findings provide a better understanding of the role of COVID-19 in amplifying cyberchondria. Based on these results, cyberchondria must be viewed as a significant public health issue. Importantly, increasing awareness about cyberchondria and online behavior at both the individual and collective levels must be prioritized to enhance preparedness and to reduce the adverse effects of current and future medical crises.

Cyberchondria: conceptual relation with health anxiety, assessment, management and prevention.

There is a need to synthesize available information on the emerging construct of cyberchondria to guide evidence informed practice. With this in mind, electronic search of databases including MEDLINE via PubMed, Cochrane Library, ScienceDirect and Google scholar were carried out from inception till March 2020 to identify relevant English language peer reviewed articles related to cyberchondria. Generated abstracts were grouped according to their thematic focus and summarized. A total of 49 articles were reviewed. Articles directly evaluating cyberchondria were very few and most of the treatment evidence was extrapolated from trials on health anxiety. Cyberchondria appears to be a phenomenologically overlapping entity with, yet distinguishable from, health anxiety and there may be merit in studying the two constructs separately. Four validated self-assessment measures for cyberchondria are available in literature. Cognitive behaviour therapy (CBT) delivered either physically or through the internet (iCBT) have been found to be effective for both health anxiety and cyberchondria. Pharmacologic strategies for health anxiety have mainly involved the use of Selective Serotonin Reuptake Inhibitors, with mean effective dosages higher than for depression/anxiety. Prevention of cyberchondria needs to focus on appropriate harm reduction strategies as well as supply and demand side measures. Internet based CBT therapies hold promise for management of cyberchondria. This finding must be considered preliminary due to limited evidence. Further study is required to establish the diagnostic validity of cyberchondria.

[Neurophysiological peculiarities of cognitive activity in patients anxiety-depressive and hypochondriacal disorders]. / Neirofiziologicheskie osobennosti kognitivnoi deiatel'nosti u patsientov s trevozhno-depressivnymi i ipokhondricheskimi rasstroistvami.

AIM: To study neurophysiological features of the cognitive activity in patients with anxiety-depressive and hypochondriacal disorders. MATERIAL AND METHODS: The study included 65 people: 16 with hypochondriacal disorder, 23 with mixed anxiety and depressive disorder, and 26 control subjects. Heart rate variability method and electroencephalography were used. RESULTS AND CONCLUSION: There was a decrease in the beta-1 frequency range in EEG after performing cognitive test in patients with mixed anxiety and depressive disorder. Patients with hypochondriacal disorder had the reduced duration of RR intervals; increased beta-1 frequency range in the resting state; the increase in the dominant beta-2 frequency during the cognitive test, and in the standard deviation of theta-wave frequencies after the cognitive test.

Acerca de un caso de síndrome referencial olfatorio / Apropos of an Olfactory Reference Syndrome case

El Síndrome Referencial Olfatorio (SRO) es una de las variedades del tipo somático del trastorno delirante y es definido por el juicio falso que el individuo afectado defiende respecto a la emisión de un olor fétido proveniente de su propio organismo y que los demás pueden advertir. En la venidera edición del Manual Diagnóstico y Estadístico de las Enfermedades Mentales (DSM-V), se ha propuesto desgajar al SRO como una patología independiente. A partir del reporte de un caso ilustrativo, revisamos la respectiva bibliografía y comentamos tal propuesta (AU)

Olfactory Reference Syndrome (ORS) is one of the varieties of the somatic type of the Delusional Disorder, and it is characterized by the mistaken statement of a patient who declares the issuance of a foul odor coming from his own body and that others may notice. In the upcoming edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) it has been proposed to break off ORS as an independent pathology. From an illustrative case report, we review the relevant literature and discuss this proposal (AU)

A prevention programme for somatoform disorders is effective for affective disorders.

OBJECTIVE: To assess the effectiveness of a psycho-educational programme for the primary prevention of somatoform disorders in healthy primary care patients. METHODS: Randomized, controlled trial. Participants (N=104) were randomly assigned to: (1) a psycho-educational intervention, or (2) no intervention at all. The primary outcome measure was somatoform disorder psychiatric diagnosis at 5-year follow-up. Secondary outcome measures were hypochondriasis, locus of control and attribution of symptoms and psychological distress. RESULTS: At 3 and 6 months, and 5 years, the intervention group significantly decreased hypochondriasis and somatic attributions; and increased psychological and normalizing attributions and internal locus of control. Five years after baseline, the prevalence of somatoform disorders showed no differences between both groups. Nevertheless, overall psychiatric morbidity was less prevalent in the intervention group (odds ratio: 2.72; 95%CI:1.10-6.72). In addition, a decrease in depression and anxiety subscales and in overall General Health Questionnaire scoring (p<.05) was found in the intervention group. CONCLUSIONS: A primary prevention programme for somatization seems to be useful, not to decrease somatoform disorders, but to prevent anxiety and depressive disorders. The effects of overlapping psychobiological mechanisms are discussed.

[Psychological consequences in women with symptomatic HPV infection]. / Conseguenze psicologiche in donne con infezione sintomatica da HPV.

OBJECTIVE: Evaluation of psychological and social aspects of women with diagnosed genital HPV-infection. EXPERIMENTAL DESIGN: A retrospective study of 40 women with a diagnosis of HPV-genital infection has been made. INTERVENTIONS AND MEASURES: A questionnaire for gathering information on social life, sexuality and emotional relationship with the partner was submitted to the patients. RESULTS: There is a high percentage of sexual impairments after diagnosis of HPV-infection. CONCLUSIONS: HPV infections, as many genital pathologies, lead to problems with sexuality as well as hypochondriac fears.

Reduction in hypochondriasis with treatment of panic disorder.

Hypochondriasis was assessed in 60 patients with panic disorder and agoraphobia using the Illness Behavior Questionnaire. Before treatment, IBQ hypochondriasis scores were similar to those of a group of hypochondriacal psychiatric patients. In patients who improved with treatment, significant reductions in somatic preoccupation, disease phobia, and disease conviction occurred. Hypochondriasis appears to be a prominent feature of panic disorder and agoraphobia, and responds to treatment of the primary conditions. Our findings underscore the importance of providing adequate treatment and thereby avoiding wasteful use of medical resources and alienation of patients from doctors.

Severe, chronic hypochondriasis.

Successful treatment of severe, chronic hypochondriasis requires the physician to focus on life situations rather than on symptoms and to set firm limits on time spent with the patient, as discussed in part 1, page 139. Part 2 discusses preventive measures aimed at curtailing hypochondriacal tendencies early in their course--obviously preferable to treatment after the condition is well established.

Management of the persistent somatizer.

Patients who suffer and complain of symptoms for which no adequate organic pathology is found present serious management problems. Patients who display somatization phenomena are discussed with respect to incidence, psychopathology and predisposing factors-social and cultural, early life experiences, personality characteristics and individual psychodynamics. Although primary prevention of somatization is not yet feasible, early recognition and treatment are possible. The role of the psychiatrist includes: formulation of diagnosis; assessment for therapy; planning of treatment; and, at times, becoming the primary therapist. The family physician has the best opportunity for early detection and prevention of chronicity of somatization phenomena. Pharmacotherapy, behavior modification and some newer approaches in the management of these persistent somatizers are discussed.