Are illness perceptions related to future healthcare expenditure in patients with somatoform disorders?

2014 ◽  
Vol 44 (13) ◽  
pp. 2903-2911 ◽  
Author(s):  
L. Frostholm ◽  
K. J. Petrie ◽  
E. Ørnbøl ◽  
P. Fink
Keyword(s):  
Illness Perceptions ◽  
Healthcare Expenditure ◽  
Somatoform Disorders ◽  
Personal Control ◽  
Somatoform Disorder ◽  
Negative Consequences ◽  
Danish Health ◽  
Physical Health Problems ◽  
Negative Perceptions ◽  
Emotional Representations

BackgroundSomatoform disorders are costly for society in terms of increased healthcare expenditure. Patients' illness perceptions have been found to play a role in somatoform disorders. However, it is unclear whether illness perceptions predict higher health costs in these patients.MethodA total of 1785 primary care patients presenting a new health complaint completed a questionnaire on their illness perceptions and emotional distress before the consultation. The physicians completed a questionnaire for each patient on diagnostics after the consultation. In a stratified subsample, physician interviewers established diagnoses of DSM-IV somatization and undifferentiated somatoform disorders (n = 144) using the Schedules for Clinical Assessment in Neuropsychiatry. Healthcare expenditure was obtained from Danish health registers for a 2-year follow-up period.ResultsPatients had more negative perceptions of their well-defined physical health problems when they had a co-morbid somatoform disorder. A strong illness identity [β = 0.120, 95% confidence interval (CI) 0.029–0.212, p = 0.012], perceived negative consequences (β = 0.010, 95% CI 0.001–0.019, p = 0.024), a long timeline perspective (β = 0.013, 95% CI 0.005–0.021, p = 0.001), low personal control (β = − 0.009, 95% CI –0.015 to −0.002, p = 0.011) and negative emotional representations (β = 0.009, 95% CI 0.002–0.017, p = 0.020) predicted healthcare expenditure in somatoform disorders.ConclusionsThe results suggest that illness perceptions play a role in the perpetuation of symptoms in somatoform disorders and predict higher future healthcare expenditure among a subgroup of these patients.

scholarly journals Illness perceptions predict distress in patients with chronic kidney disease

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Priscilla Muscat ◽  
John Weinman ◽  
Emanuel Farrugia ◽  
Roberta Callus ◽  
Joseph Chilcot
Keyword(s):  
Chronic Kidney Disease ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Illness Perceptions ◽  
Personal Control ◽  
Hierarchical Regression ◽  
Hierarchical Regression Analysis ◽  
Morbidity Score ◽  
Advanced Stages ◽  
Emotional Representations

Abstract Background Patients diagnosed with chronic kidney disease (CKD) report increased distress associated with their clinical diagnosis. Distress in patients with predialysis CKD, has been linked to several adverse events; including increased risk of hospitalisation, early dialysis initiation and even death, suggesting that distress is a matter of great concern during routine care in predialysis CKD. Aims The present study aimed to assess the nature of illness perceptions and the level of distress in a CKD cohort diagnosed with different stages of kidney disease. It also aimed to explore the correlates of distress and to create a model for distress and its associated predictors making use of hierarchical regression analysis. Methods A sample of 200 patients diagnosed with Chronic Kidney Disease were recruited for this study from the nephrology outpatient clinics of Mater Dei Hospital, Malta. The participants were assessed for their; illness perceptions, treatment beliefs, level of depression and anxiety, coping style, as well as treatment adherence. Routine clinical information was also collected for participants, including a co-morbidity score. Results A percentage of 33.5% of the participants reported moderate distress, whilst 9.5% reported severe distress. Stronger illness identity, a perception of timeline as being increasingly chronic or cyclical in nature, greater consequences and higher emotional representations were associated with more advanced stages of CKD. In contrast, lower personal and treatment control and poorer illness coherence were associated with more advanced stages of CKD. Results from the hierarchical regression analysis showed that illness perceptions contributed significantly to distress over and above the clinical kidney factors. Being female, having low haemoglobin and specific illness perceptions including; perceptions of greater symptomatology, longer timeline, low personal control and strong emotional representations, as well as resorting to maladaptive coping, were all significantly associated with distress symptoms. Nevertheless, illness perceptions accounted for the greatest variance in distress thus indicating that the contribution of illness perceptions is greater than that made by the other known covariates. Conclusion Illness perceptions hold a principal role in explaining distress in CKD, relative to other traditional covariates. For this reason, illness perceptions should be addressed as a primary modifiable component in the development of distress in CKD.

Challenges in the Diagnostic Conceptualization of CRPS-1 (Formerly Conceptualized as RSD)

2006 ◽  
Vol 11 (2) ◽  
pp. 1-3, 9-12
Author(s):  
Robert J. Barth ◽  
Tom W. Bohr
Keyword(s):  
Clinical Practice ◽  
Complex Regional Pain Syndrome ◽  
Somatoform Disorders ◽  
International Association ◽  
Pain Syndrome ◽  
Somatoform Disorder ◽  
Syndrome Type ◽  
Previous Issue

Abstract From the previous issue, this article continues a discussion of the potentially confusing aspects of the diagnostic formulation for complex regional pain syndrome type 1 (CRPS-1) proposed by the International Association for the Study of Pain (IASP), the relevance of these issues for a proposed future protocol, and recommendations for clinical practice. IASP is working to resolve the contradictions in its approach to CRPS-1 diagnosis, but it continues to include the following criterion: “[c]ontinuing pain, which is disproportionate to any inciting event.” This language only perpetuates existing issues with current definitions, specifically the overlap between the IASP criteria for CRPS-1 and somatoform disorders, overlap with the guidelines for malingering, and self-contradiction with respect to the suggestion of injury-relatedness. The authors propose to overcome the last of these by revising the criterion: “[c]omplaints of pain in the absence of any identifiable injury that could credibly account for the complaints.” Similarly, the overlap with somatoform disorders could be reworded: “The possibility of a somatoform disorder has been thoroughly assessed, with the results of that assessment failing to produce any consistencies with a somatoform scenario.” The overlap with malingering could be addressed in this manner: “The possibility of malingering has been thoroughly assessed, with the results of that assessment failing to produce any consistencies with a malingering scenario.” The article concludes with six recommendations, and a sidebar discusses rating impairment for CRPS-1 (with explicit instructions not to use the pain chapter for this purpose).

The Negative Consequences of Stuttering for Perceptions of Leadership Ability

2020 ◽  
pp. 1-8
Author(s):  
Virgil Zeigler-Hill ◽  
Avi Besser ◽  
Yuval Besser
Keyword(s):  
Self Esteem ◽  
Negative Association ◽  
Negative Consequences ◽  
Community Members ◽  
Perceived Leadership ◽  
Negative Perceptions ◽  
Low Levels ◽  
Perceptions Of Leadership

Abstract. The purpose of the present study was to extend previous research concerning the negative perceptions of stuttering by considering the perceived leadership ability of targets who stuttered compared with targets who did not stutter. We were also interested in the possibility that negative perceptions of the targets (i.e., low levels of self-esteem, intelligence, dominance-based status motivation, and prestige-based status motivation) would mediate the association between stuttering and a lack of perceived leadership ability as well as the possibility that manipulating the ostensible self-esteem level of the target would further moderate these associations. The results for 838 Israeli community members revealed a negative association between stuttering and perceived leadership ability that was mediated by the perceived self-esteem level and dominance-based status motivation of the target. Further, the associations between stuttering and perceptions of leadership ability were moderated by the ostensible self-esteem level of the target. Discussion focuses on the implications of these results for understanding the negative halo that surrounds stuttering.

Somatoform disorders: A help or hindrance to good patient care?

2004 ◽  
Vol 184 (6) ◽  
pp. 465-467 ◽  
Author(s):  
Michael Sharpe ◽  
Richard Mayou
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
General Practitioners ◽  
Somatoform Disorders ◽  
Somatoform Disorder ◽  
Good Patient ◽  
Specific Category ◽  
Good Patient Care ◽  
Almost All ◽  
Issue Reports

The paper by de Waal and colleagues (2004, this issue) reports on the prevalence of somatoform disorders in Dutch primary care. They found that at least one out of six patients seen by general practitioners could be regarded as having a somatoform disorder, almost all in the non-specific category of undifferentiated somatoform disorder. The prevalence of the condition has major implications for medical services but what does this diagnosis mean? Is receiving a diagnosis of somatoform disorder of any benefit to the patient? Does it help the doctor to provide treatment?

scholarly journals Gender, Flexibility Stigma and the Perceived Negative Consequences of Flexible Working in the UK

2018 ◽  
Vol 151 (2) ◽  
pp. 521-545 ◽  
Author(s):  
Heejung Chung
Keyword(s):  
Gender Differences ◽  
Work Life ◽  
Working Time ◽  
Work Life Balance ◽  
Negative Consequences ◽  
Life Balance ◽  
Flexible Working ◽  
Part Time ◽  
Negative Perceptions ◽  
The Uk

AbstractThis study examines the prevalence and the gender differences in the perceptions and experiences of flexibility stigma—i.e., the belief that workers who use flexible working arrangements for care purposes are less productive and less committed to the workplace. This is done by using the 4th wave of the Work-Life Balance Survey conducted in 2011 in the UK. The results show that 35% of all workers agree to the statement that those who work flexibly generate more work for others, and 32% believe that those who work flexibly have lower chances for promotion. Although at first glance, men are more likely to agree to both, once other factors are controlled for, women especially mothers are more likely to agree to the latter statement. Similarly, men are more likely to say they experienced negative outcomes due to co-workers working flexibly, while again mothers are more likely to say they experienced negative career consequences due to their own flexible working. The use of working time reducing arrangements, such as part-time, is a major reason why people experience negative career outcomes, and can partially explain why mothers are more likely to suffer from such outcomes when working flexibly. However, this relationship could be reverse, namely, the stigma towards part-time workers may be due to negative perceptions society hold towards mothers’ commitment to work and their productivity. In sum, this paper shows that flexibility stigma is gendered, in that men are more likely to discriminate against flexible workers, while women, especially mothers, are more likely to suffer from such discrimination.

Association between socio-demographic factors, coping style, illness perceptions and preference for disclosure/nondisclosure of diagnosis in Chinese patients with hepatocellular carcinoma

2017 ◽  
Vol 24 (11) ◽  
pp. 1473-1483
Author(s):  
Bin Jie ◽  
Zheng-Zhi Feng ◽  
Yan Qiu ◽  
Yan-qi Zhang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cancer Diagnosis ◽  
Coping Style ◽  
Illness Perceptions ◽  
Demographic Factors ◽  
Personal Control ◽  
Chinese Patients ◽  
Emotional Impact ◽  
Psychosocial Perspective ◽  
Socio Demographic Factors

We explored the association between socio-demographic factors, coping style, illness perceptions and preferences for disclosure/nondisclosure of cancer diagnosis in 384 Chinese patients with hepatocellular carcinoma. We found that (1) 69.3 percent of the patients preferred disclosure and (2) multivariate analysis showed that four variables were significantly positively associated with preference for disclosure, including active emotional-focused coping style, illness perceptions of personal control, chronic infection of hepatitis B virus, and educational level, whereas perceived emotional impact of illness and objective social support (mainly family support) were significantly associated with preference for nondisclosure. The findings provide useful information for understanding patients’ preferences for disclosure/nondisclosure of cancer diagnosis from a psychosocial perspective.

Mammography Adherence among High-Risk Women with Breast Cancer and Either a Non-Pathogenic Mutation Identified or Untested BRCA1/2 Genetic Status

2020 ◽  
Vol 1 (1) ◽  
pp. 29-42
Author(s):  
Alison Flehr ◽  
Fiona Judd ◽  
Geoffrey J. Lindeman ◽  
Maira Kentwell ◽  
Penny Gibson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Illness Perceptions ◽  
Response Rate ◽  
Familial Cancer ◽  
Pathogenic Mutation ◽  
Self Report ◽  
Middle Income ◽  
Income Status ◽  
Emotional Representations ◽  
The Impact

Background: Little is known about the illness perceptions of women with a previous breast cancer diagnosis and either no access to a personal BRCA1/2 test or tested and a no pathogenic mutation identified result and how this might impact their mammography adherence. Objective: The aim of this study was to assess the impact of illness beliefs, specifically those relating to emotional representations and cure and control beliefs about breast cancer, and socio-economic status (SES) on mammography adherence of these women. The traditional health belief model (HBM) was compared to a modified model which allowed for the contribution of emotions in health surveillance decision-making. Method: Mailed self-report questionnaires were completed by 193 women recruited from an Australian Familial Cancer Centre. Step-wise logistic regression analyses were conducted on n=150 [aged 27-89 years (M=56.9)] for whom complete data were available. Results: The questionnaire response rate was 36%. Higher levels of emotional representations of breast cancer were associated with greater mammography adherence (OR = 1.18, 95% CI = 1.03-1.36, p =.019). Middle income was six times more likely to predict mammography adherence than lower income (OR = 6.39, 95% CI = 1.03 – 39.63, p =.047). The modified HBM was superior to the traditional HBM in predicting mammography adherence (X2 [15, N = 118] = 26.03, p =.038). Conclusions: Despite a modest response rate, our data show that emotional illness representations about breast cancer and middle income status were found to significantly predict mammography adherence. Therefore, providing surveillance services and delivering information considerate of financial status and constructed around emotional motivators may facilitate mammography adherence among women like those described in this study.

CS03-04 - Concept of somatoform disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 1777-1777
Author(s):  
H.-P. Kapfhammer
Keyword(s):  
Anxiety Disorders ◽  
Somatoform Disorders ◽  
Diagnostic Category ◽  
Somatic Symptoms ◽  
Somatoform Disorder ◽  
The Other ◽  
Critical Issues ◽  
Medically Unexplained ◽  
The One ◽  
Medically Unexplained Somatic Symptoms

Patients presenting with bodily symptoms and complaints that are not sufficiently explained by organic pathology or well known pathophysiological mechanisms present a major challenge to any health delivery system. From a perspective of psychiatric classification these medically unexplained somatic symptoms may be diagnosed as primary psychiatric disorders such as depressive and anxiety disorders on the one hand, as somatoform disorders on the other. Among medical specialties a separate diagnostic approach is taken to conceptualize functional somatic syndromes. Unfortunately, both diagnostic systems do not conform to each other very well.The concept of somatoform disorders as outlined in DSM-III to DSM-IV-TR and in ICD-10 refers to a group of heterogeneous disorders with prominent somatic symptoms or special body-focussed anxieties, or convictions of illness. These disorders seem to indicate medical conditions that cannot, however, fully be explained either in terms of medical diagnostics or of other primary psychiatric disorders. There is one major conceptual assumption that postulates a decisive impact of psychosocial stress on the origin, onset and/or course of these somatic symptoms and complaints. And there is one major path of diagnostic steps to be taken, i.e. just to count the number of medically unexplained somatic symptoms, to determine their reference to any main organ system, to prove that they are not self-induced, to put special stress on prevailing pain symptoms and to separately assess dominant health anxieties or illness convictions.Since introduction of the diagnostic concept of somatoform disorders there have been arising many critical issues regarding the soundness of this diagnostic category. These issues, among other things, refer to a problematic mind-body dichotomy overemphasizing psychosocial and psychological factors and neglecting major neurobiological processes, to the impracticable criterion of “medically unexplained”, to the demand of conceptual clarity and coherence of this diagnostic category, to the rather trivial diagnostic procedure of just counting the number of medically unexplained somatic symptoms whereas not assessing typical dimensions of illness behaviour in a corresponding way, to the major overlap between subgroups of somatoform disorders on the one hand and factitious disorders, anxiety disorders and depressive disorders on the other, to a principal focus on the epidemiologically rare condition of somatisation disorder as core disorder thereby undervaluing much more prevalent subthreshold conditions, to the difficult communication of the whole diagnostic group to medical colleagues dealing with the same problems by using a different conceptual approach, however.These critical issues surrounding the concept of somatoform disorder will be reflected in respect of some major revisions projected in future diagnostic classification systems of DSM-V and ICD-11.

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