دورية أكاديمية
أعرض في EDS

Mechanistic studies in pathological health anxiety: A systematic review and emerging conceptual framework.

التفاصيل البيبلوغرافية
العنوان: Mechanistic studies in pathological health anxiety: A systematic review and emerging conceptual framework.
المؤلفون: Guthrie AJ; Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Paredes-Echeverri S; Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Bleier C; Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Adams C; Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Millstein DJ; Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Ranford J; Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Occupational Therapy, Massachusetts General Hospital, Boston, MA, USA., Perez DL; Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: dlperez@nmr.mgh.harvard.edu.
المصدر: Journal of affective disorders [J Affect Disord] 2024 Aug 01; Vol. 358, pp. 222-249. Date of Electronic Publication: 2024 May 06.
نوع المنشور: Journal Article; Systematic Review
اللغة: English
بيانات الدورية: Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Netherlands NLM ID: 7906073 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2517 (Electronic) Linking ISSN: 01650327 NLM ISO Abbreviation: J Affect Disord Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Amsterdam, Elsevier/North-Holland Biomedical Press.
مواضيع طبية MeSH: Anxiety Disorders*/physiopathology , Anxiety Disorders*/psychology , Hypochondriasis*/psychology, Humans
مستخلص: Background: Pathological health anxiety (PHA) (e.g., hypochondriasis and illness anxiety disorder) is common in medical settings and associated with increased healthcare costs. However, the psychological and neurobiological mechanisms contributing to the development and maintenance of PHA are incompletely understood.
Methods: We performed a systematic review to characterize the mechanistic understanding of PHA. PubMed, PsycINFO, and Embase databases were searched to find articles published between 1/1/1990 and 12/31/2022 employing a behavioral task and/or physiological measures in individuals with hypochondriasis, illness anxiety disorder, and PHA more broadly.
Results: Out of 9141 records identified, fifty-seven met inclusion criteria. Article quality varied substantially across studies, and was overall inadequate. Cognitive, behavioral, and affective findings implicated in PHA included health-related attentional and memory recall biases, a narrow health concept, threat confirming thought patterns, use of safety-seeking behaviors, and biased explicit and implicit affective processing of health-related information among other observations. There is initial evidence supporting a potential overestimation of interoceptive stimuli in those with PHA. Neuroendocrine, electrophysiology, and brain imaging research in PHA are particularly in their early stages.
Limitations: Included articles evaluated PHA categorically, suggesting that sub-threshold and dimensional health anxiety considerations are not contextualized.
Conclusions: Within an integrated cognitive-behavioral-affective and predictive processing formulation, we theorize that sub-optimal illness and health concepts, altered interoceptive modeling, biased illness-based predictions and attention, and aberrant prediction error learning are mechanisms relevant to PHA requiring more research. Comprehensively investigating the pathophysiology of PHA offers the potential to identify adjunctive diagnostic biomarkers and catalyze new biologically-informed treatments.
Competing Interests: Declaration of competing interest D.L.P. has received royalties for a Springer Nature textbook on functional movement disorder; is a paid senior editor at Brain and Behavior; has received honoraria for a functional neurological disorder textbook and continuing medical education lectures; has received funding from the Sidney R. Baer Jr. Foundation unrelated to this work; and is on the editorial boards of The Journal of Neuropsychiatry & Clinical Neurosciences, Epilepsy & Behavior, and Cognitive and Behavioral Neurology. All other authors do not have any disclosures or other conflicts of interest.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
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معلومات مُعتمدة: R01 MH125802 United States MH NIMH NIH HHS
فهرسة مساهمة: Keywords: Cyberchondria; Health anxiety; Hypochondriasis; Illness anxiety disorder; Pathological health anxiety
تواريخ الأحداث: Date Created: 20240508 Date Completed: 20240527 Latest Revision: 20240806
رمز التحديث: 20240806
مُعرف محوري في PubMed: PMC11298870
DOI: 10.1016/j.jad.2024.05.029
PMID: 38718945
قاعدة البيانات: MEDLINE
الوصف
تدمد:1573-2517
DOI:10.1016/j.jad.2024.05.029