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Hypochondriasis: common presentations and treatment strategies in primary care and specialty settings

机译:软骨病:在初级保健和特殊情况下的常见表现和治疗策略

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摘要

Hypochondriasis is a somatoform disorder marked by recurrent preoccupation with fears of having a life-threatening disease despite appropriate work-up and medical reassurance. The etiological explanations for hypochondriasis have evolved over time from a psychoanalytic stance (as an unconscious manifestation of instinctual drives) to social learning, cognitive–behavioral, and biological models that focus on functional values of hypochondriasis and parallels to anxiety disorders. We review recent therapeutic developments while emphasizing the importance of the therapeutic alliance. Although reassurance, psychotherapy, psychopharmacology and mental health referral are clearly indicated, we caution against using them prematurely. Since primary care and nonpsychiatric specialty physicians care for the majority of patients with hypochondriasis, we review the clinical presentations and treatment nuances specific to several different settings.
机译:软骨病是一种躯体形式的疾病,其特征是反复发作,尽管进行了适当的检查和医疗保证,但仍担心会危及生命。软骨病的病因学解释已经随着时间的流逝而从精神分析立场(作为本能驱动的无意识表现)发展为注重于软骨病功能价值和与焦虑症相似的社会学习,认知行为和生物学模型。我们在强调治疗联盟的重要性的同时回顾了近期的治疗进展。尽管明确表示可以放心,进行心理治疗,进行心理药理学和进行心理健康转诊,但我们仍建议不要过早使用它们。由于初级保健和非精神病专科医师会照顾大多数患有软骨病的患者,因此我们回顾了针对几种不同情况的临床表现和治疗差异。

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