Illness behaviour in neurological inpatients with psychiatric morbidity

Objective.The aim of the present study was to examine whether psychiatric morbidity can influence the type of illness behaviour of neurological inpatients.Methods.For this purpose, we compared neurological inpatients with and without psychiatric disorders (DSM-IIIR criteria) for the seven scales of Illness Behaviour Questionnaire (IBQ) and searched for possible differences between the two patient subgroups.Results.Of the 105 neurological inpatients who participated in the study, 54 (51.4%) were diagnosed as having some type of psychiatric disorder. These patients scored significantly higher than patients without psychiatric morbidity in the scale of Irritability. A suggestive trend for higher scores in the scales of Hypochondriasis, Disease Conviction, and Affective Disturbance, and significantly lower score in the scale of Denial, in patients with psychiatric morbidity, were also found.Conclusion.The present study has shown that neurological inpatients with psychiatric morbidity tend to develop more intense illness behaviour than those without. The effect of psychiatric morbidity on certain components of illness behaviour in neurological patients can be taken into account when therapeutic strategies are planned.

Convergent Validation of the Illness Effects Questionnaire

The Illness Effects Questionnaire, Illness Behavior Questionnaire, and visual analog scales of mood were given to 100 adults with nonmalignant headaches. Using regression analysis, scores on IBQ Disease Conviction, IBQ Irritability, and depression accounted for 50.6% of the variance in predicting IEQ scores. Scores on the Illness Effects Questionnaire correlated with the Illness Behavior Questionnaire subscales of General Hypochondriasis (.33), Disease Conviction (.60), Affective Disturbance (.49), and Irritability (.40), and also with rated depression (.38) and anxiety (.26).

Hypochondriacal Fears and Beliefs, Anxiety, and Somatisation

Four self-rating scales of hypochondriasis and the Symptom Checklist-90 were administered to 100 general practice (GP) patients and matched non-psychotic psychiatric out-patients. In a stepwise linear regression, self-rated somatic symptoms and anxiety predicted hypochondriacal fears and beliefs; self-rated depression did not appear as a predictor. There were differences between males and females and between psychiatric patients and GP patients in the associations of these constructs. These results varied in part with the scale of hypochondriasis used. Various scales of hypochondriasis appear to measure different features of the hypochondriasis syndrome. Fear of disease (disease phobia) was associated with anxiety, whereas a false belief of having a disease (disease conviction) was associated more with somatic symptoms.

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.