Illness Behaviour Questionnaire Research Articles

The Correlation of Pain, Psychological Aspects, and Sleep in Fibromyalgia: A Cross-Sectional Analysis.

This pilot study measures pain perception, somatosensory amplification and its relationship to health anxiety in patients with fibromyalgia (FM) and patients with FM and obstructive sleep apnea (OSA); this study also examines the effects of OSA on pain perception in patients with FM. In this pilot study, patients diagnosed with FM or FM and OSA, completed three self-reported questionnaires: Short-Form McGill Pain Questionnaire (SF-MPQ), Somatosensory Amplification Scale (SSAS), and Illness Behavior Questionnaire (IBQ). Sleep study results were analyzed. Scores were summarized using medians and interquartile ranges and are compared using Wilcoxon rank sum tests. Overall FM (n = 25), female n=23 male n=3 mean age, 57.48 years. OSA n=17 (68%) and 8 (32%) were not. The SF-MPQ Sensory sub-scale scores and the SF-MPQ overall scores differed significantly between patients with and without OSA. The SF-MPQ Sensory sub-scale scores were significantly lower for patients with OSA (p=0.03), as were SF-MPQ overall scores (p=0.04). SSAS overall scores and IBQ overall scores did not differ significantly by OSA diagnosis. Correlations of the different dimensions of IBQ with SSAS and mean number of diagnoses in FM and FM+OSA, mean number of diagnoses in problem list of SSAS ≤30 was 29.5, mean number of diagnoses in SSAS ≥30 was 34.9. Developing a better understanding of the effects of OSA on pain perception in patients with FM is needed for improved health status. More research is needed to see if higher pain perception and SSAS score lead to increased health care utilization and to evaluate the relationship between untreated disordered sleeping and pain perception in patients with FM. Our findings highlight the need for more research to evaluate the relationship between treated and untreated disordered sleeping, pain perception, somatization and illness behavior in the health status of individuals with FM.

Clinical-Psychological Aspects Involved in Gynecological Surgery: Description of Peri-Operative Psychopathological Symptoms and Illness Behavior.

Within the current literature concerning the gynecological surgery, there are only a few studies that focus on the psychological aspects that characterize the peri-operative period. In this research, the psychopathological symptoms and the illness behavior were assessed in order to confirm previous results about clinical variables such as the type and method of intervention, as well as psychological aspects regarding the positive anamnesis for mental disorders. Moreover, other factors including the desire for maternity and previous surgical interventions and pregnancies were also investigated. In this observational research, 58 women (age = 41.5±8.8), that undergone gynecological surgery (conservative and non-conservative) for benign pathologies, were consecutively recruited. Information on psychopathological symptoms was collected 15 days (T0) and one day before surgery (T1), and at the time of discharge (T2) through the Symptom Questionnaire (SQ). At T2, the Illness Behavior Questionnaire (IBQ) was also administered. The descriptive analyzes conducted on the total sample demonstrated that while anxious activation and irritable mood decrease from T0 to T1, somatizations and depression mood increase between T1 and T2. Moreover, the comparisons between groups, dividing the sample according to the clinical-medical and psychological variables, highlighted that the type and modality of the intervention, as well as a positive history for the presence of psychological disorders, the desire for maternity, and previous surgical interventions and pregnancies, can influence the course of psychopathological symptoms. This study highlights the need to include a clinical-psychological evaluation and to pay attention to specific clinical variables regarding women that are undergoing a conservative or non-conservative gynecological surgery. Considering the psychological impact of these type of interventions, the clinical history of these women, as well as their fears and desires, could facilitate a better management of the patients in terms of well-being, adherence to treatment, and recovery.

COMPARISON OF HEALTH ANXIETY IN PSYCHIATRY AND NEUROLOGY SETTINGS

The aim of this study is to assess clinical correlates and prevalence of health anxiety in psychiatry and neurology outpatient clinic. A Prospective study was carried out at Neurology and psychiatry Department of Nishtar Medical Hospital from July 2020 to July 2021. Demographic data, clinical symptoms, comorbidities and diagnosis was recorded. Patients were given general hypochondriasis subscale of Illness Behavior Questionnaire and Short Health Anxiety Inventory (SHAI). Epi-info 7.013 was used for data entry and Stata 12.14 was used for data analysis. The prevalence of health anxiety in neurology and psychiatry was 18% and 26%, and overall prevalence was 21%. Higher health anxiety was reported in subjects with higher education, it may be due to increased awareness about illness. Health anxiety was higher in skilled workers as compared to semi skilled. The health anxiety was higher in subjects with more than one diagnosis as compared to those with single diagnosis Health anxiety is common in neurology and psychiatry settings. Further evaluation is needed to evaluate its effects on health consultation.

Comparison of Illness Behavior between Japanese and Chinese Patients with Somatoform Disorders

Aims: To clarify the differences between Japan and China regarding illness behavior of outpatients with somatoform disorders.
 Study Design: Cross-sectional study.
 Place and Duration of Study: A survey on psychiatric and psychological outpatients with somatoform disorders between Japan and China. Duration of this study was three months between April 1, 2011, and June 30, 2011.
 Methodology: The subjects of this research included 43 Japanese outpatients (49.7±10.5 yr., M/F:13/30) in psychiatry clinic at Saga Medical School Hospital, Saga 845-8502, Japan. It also included 38 Chinese outpatients (40.7±8.2 yr., M/F: 14/24) in psychiatry and psychology outpatient clinic in Dalian Medical University Hospital, Liaoning province, China. All psychiatric patients were diagnosed as the somatoform disorders according to the DSM-IV. To investigate the difference of psychological status and illness behavior, we examined them using two psychological instruments: Illness Behavior Questionnaire (IBQ) and General Health Questionnaire-30 (GHQ-30).
 Results: It can be found that there were the remarkable statistical differences between the Japanese and Chinese patients with somatoform disorders of each of the subscales of the GHQ-30. All GHQ-30 items were scored significantly higher by the Chinese than by the Japanese. Regarding the IBQ, the statistical differences of five subscales of IBQ between the two groups: General Hypochondriasis, Disease Conviction, Affective Inhibition, Affective Disturbance, and Irritability can be found. No obvious difference was found between the two groups of the subscale of Psychological versus somatic focusing (P/S) and Denial (D), however.
 Conclusion: The GHQ-30 and the other five subscales of IBQ (except for P/S and D) for Chinese was higher than for Japanese. This finding may be attribute to the socio-cultural and economic factors. P/S and D scores on the IBQ were not significantly different, suggesting the possibility of an essential symptom of somatoform disorders.

Gynecological surgical interventions (conservative and non-conservative): Clinical psychological variables and symptomatology pertaining to perioperative period

Objective: After considering great inter-individual variability of subjective experience and clinical course in reference to conservative and non-conservative gynecological surgical interventions, an attempt was made to evaluate potential role of several clinical and psychological variables with respect to perioperative symptomatology course and illness behaviour. Materials and methods: The sample consists of 58 women (mean age 41.4 ± 8.7) undergoing gynecological surgical interventions (conservative and non-conservative ones) for benign pathologies. The anamnestic and clinical data (psychological anamnesis, clinical history, indications, methods and typology of the intervention) were collected using a specifically designed summary form. For the evaluation of pre-and post-operative symptomatology course and illness behaviour, the following psychological tests were respectively used: The Symptom Questionnaire (SQ), with 3 planned administrations (respectively 15 days before the intervention, a day before the intervention and at discharge) and the Illness Behavior Questionnaire (IBQ), completed before discharge. Non-parametric tests (Mann-Whitney and Kruskal-Wallis) were used to compare performances on independent samples. Results: Results show that perioperative course and illness behaviour in the cases of gynecological surgical interventions for benign pathologies depend on clinical variables, that is, typology and methods of the intervention, clinical history, psychopathological anamnesis. Conclusion: Findings suggest the importance of clinical-anamnestic inquiry oriented towards the evaluation of variables that emerged as risk factors, with the goal of planning personalized support interventions for preventing and/or reducing distress and impact on psychophysical wellbeing arising after gynaecological surgical interventions.

Illness Behavior: Pain Clinic Patients vs. Psychiatry Clinic Patients

Aims: To investigate the difference of illness behavior with pain between psychiatric and pain clinic outpatient.
 Study Design: Cross-sectional study
 Place and Duration of Study: A survey on psychiatric and pain outpatients, Saga Medical School, Saga 849-8501, Japan. Duration of this study was three months between April 1, 2011, and June 30, 2011.
 Methodology: The subjects of this research included 40 patients (62.9±16.5 yr., M/F:15/25) in pain clinic outpatients and 43 patients (49.7±15.9 yr., M/F:13/30) in psychiatric clinic outpatient. Psychiatric patients were diagnosed as the somatoform disorders according to the DSM-IV. To clarify the difference of psychological status and illness behavior, we examined them using two psychological instruments: Illness Behavior Questionnaire (IBQ) and General Health Questionnaire-12 (GHQ-12).
 Results: Pain clinic patients’ group was significantly older than psychiatric patient’s group. In terms of IBQ, the scores of psychological vs. somatic perception and affective disturbance among psychiatric outpatient group were significantly higher than those of pain clinic group. On the other hand, the score of denial among pain clinic group was significantly higher than those of psychiatric outpatient group.
 Conclusion: According to the IBQ, the subscale of denial has significant difference between the pain clinic patients and the psychiatric patients with pain. Pain clinic patients tend to deny their psychological problem.

Self-Medication with Over-the-Counter and Prescription Drugs and Illness Behavior in Nigerian Artisans

Background: Self-medication (SM), the use of drugs by individuals to treat self-recognized illnesses or symptoms is one of the major health problems. Objectives: The study assessed the patterns and links between SM and illness behavior in Nigerian artisans. Patients and Methods: In this cross-sectional survey, a multistage sampling procedure was employed to select 186 participants (age range = 15 - 61 years; mean = 31.5) in the Ede community of Osun State, Southwestern Nigeria. The artisans (beauticians, autoworkers, and house building construction workers) responded to the self-medication test (SMT) and Illness Behavior Questionnaire (IBQ). Frequency counts were employed to analyze the participants' demographic characteristics, while linear regression analysis was used to answer the research question. Results: The findings from this study revealed a 47.8% prevalence of SM, ranging from 14.2% of antibiotics SM to 51.1% of alternative medicine SM. SM was observed to independently and significantly predict disease conviction (R2 = 0.030, P = 0.018), psychological/somatic perception (R2 = 0.034, P = 0.012), general illness reaction (R2 = 0.064, P = 0.000), and general illness behavior (R2 = 0.028, P = 0.023) of the participants. Conclusions: Our findings revealed the need for an increase in public enlightenment, awareness, and sensitization among artisans on ills of SM. Also, we recommend psycho-education among this vulnerable group.

A retrospective observational study comparing somatosensory amplification in fibromyalgia, chronic pain, psychiatric disorders and healthy subjects.

Somatosensory amplification (SA) has been described as an important feature of somatoform disorders, and an "amplifying somatic style" has been reported as a negative connotation of body perception. As widespread pain (WSP) in fibromyalgia (FM) is due to a central sensitization (CS) rather than organic alterations, there has been discussion as to whether FM is equivalent to or distinct from somatization disorder (SD). Assuming SD and FM are two distinct entities, an increase in somatic amplification should be expected only in subjects who have SD, regardless of the type of pain they experience. Purpose of the study was to explore the magnitude of SA in FM, and whether this depends on the association with SD. FM (n=159) other forms of chronic pain (OCP, n=582), psychiatric (Psy, n=53) and healthy (H, n=55) subjects were investigated using the Somatosensory Amplification Scale (SSAS), Illness Behavior Questionnaire, (IBQ), Italian Pain Questionnaire (IPQ), and Cold Pressor Test (CPT) in a retrospective observational study. FM subjects displayed higher SSAS scores than the other groups. High SSAS score was associated with FM (OR=8.39; 95%CI: 5.43-12.46) but not OCP. Although FM has the highest prevalence of SD (x2=14.07; p=.007), high SSAS scores were associated with SD in OCP but not in FM. Unlike in OCP, in FM high SSAS scores were independent of the presence of SD. From a biopsychosocial perspective, SSAS may be a factor associated with the onset of FM.

The burden of non-specific chronic low back pain among adults in KwaZulu-Natal, South Africa: a protocol for a mixed-methods study.

IntroductionLow back pain (LBP) is a major public health concern, affecting individuals of all age groups across the world. In about 90% of LBP cases, there is no specific cause identified and is, therefore, referred to as non-specific LBP. Due to the non-specific nature of LBP, investigations such as radiological and laboratory investigations are unnecessary and results to delayed diagnosis and improper treatment culminating in LBP progressing into chronic LBP (CLBP). LBP is now the leading cause of disability with a significant socioeconomic burden. Despite all these challenges, CLBP is regarded as a trivial condition in low-and-middle-income countries and remains poorly investigated. The distribution of CLBP in Africa is unclear.Methods and analysisThe research will be conducted in two phases. The initial phase will be an observational, cross-sectional hospital-based study that will be recruiting 650 participants, to determine the prevalence and risk factors of CLBP. A standardised questionnaire will be used to collect baseline data on the socio-demographic characteristics of participants and other variables of interest (exercise history, occupational posture, level of education and the income status). Disability will be assessed using the Oswestry Disability Questionnaire and the psychological risk factors will be assessed using the Illness-Behaviour Questionnaire (IBQ) and the Fear-Avoidance Belief Questionnaire (FABQ). The second phase will be a retrospective, top-down, prevalence-based cost-of-illness study of the 2018–2019 health records, to estimate the burden of CLBP from the healthcare system’s perspective. The SPSS V.25.0 statistical package will be used for data entry and analysis. Statistical analysis will include descriptive statistics by means of graphs and cross tabulations, inferential statistics by means of logistic regression and χ2 test. A p value of 0.05 will be deemed statistically significant.Ethics and disseminationThis protocol was approved by the University of KwaZulu-Natal’s Biomedical Research Ethics Committee (Ref. No.: BREC/00000205/2019) and the KwaZulu-Natal Department of Health Research Ethics (Ref. No.: KZ_201909_002). This will be the first LBP cost-of-illness study in the sub-Saharan Africa, and, therefore, it will close these knowledge gaps and present important evidence on the estimated burden of CLBP in this context. The results of this study will be presented to the Department of Health and to the respective stakeholders and decision-makers to discuss the findings and draw their attention to the prioritisation of LBP research, its management, prevention programmes and implementation of educational programme and for the planning of cost-containment policies.

Ποιότητα Ζωής Σχετιζόμενη με την Υγεία σε Άτομα Τρίτης Ηλικίας: Αξιολόγηση και Σύγχρονες Εφαρμογές

Introduction: In recent years there has been a growing interest in the investigation of the quality of life (QOL) in elderly patients. Purpose: The examination of the psychometric properties of the Greek version of the Missoula-Vitas Quality of Life Index-15 (MVQOLI) questionnaire, the shortest form of the MVQOLI-25, as well as the Illness Effects Questionnaire (IEQ) in a sample of elderly patients. Material and method: The Greek version includes the 15 questions of the English prototype, while the study of the questionnaire was based on a sample of 79 elderly subjects consisting of patients with chronic renal failure of end stage who were attending a dialysis program (HD). The questionnaire consists of five dimensions (symptoms, functionality, interpersonal relationships, wellbeing, spirituality) and the overall score. The statistical analyses carried out relate to the measurement of internal validity, repeatability, the agreement of the replies (test, re-test reliability), as well as the convergent validity with the statistical programme Statistical Package for Social Sciences (SPSS), version 23.0. The IEQ questionnaire also examined the reliability and validity of different groups of elderly chronic patients. Results: The internal validity of the MVQOLI-15 was satisfactory, with the total score of Cronbach's alpha being 0.74. Regarding the convergent validity, significant correlations were identified between the overall score and the five dimensions. The test, re-test reliability (Pearson’s r και ICC values) was excellent, with values ranging from 0,91 to 0,98. In a general population of elderly patients, IEQ had excellent short-term R = 0.99 measure- ments while in a population of elderly people with spinal injuries, the two-day reliability coefficient was R = 0.95. IEQ developed relatively strong relationships with Illness Behavior Questionnaire in a population of 121 elderly patients with chronic pain and arthritis. Conclusions: The above questionnaires are reliable and valid tools to assess the QOL.

Can a Peer Support the Process of Self-Management in Narcolepsy? A Qualitative Narrative Analysis of a Narcoleptic Patient.

IntroductionNarcolepsy type 1 (NT1) is a chronic and rare sleep disorder typically arising during adolescence and young adulthood. The main symptoms are excessive daytime sleepiness and cataplexy, a prototypical fall down elicited by huge emotions. Social relationships, school, work, and general health perception are frequently impaired in patients, who often show lower quality-of-life scores. We report which management strategies a young patient (DMG) adopted to cope with NT1 during his growth, avoiding exhibiting serious impairments to his global functioning.MethodsA clinical psychologist explores the history of the patient’s disease and the self-acquired strategies used to cope with the symptoms. The patient’s global adaptation to the disease, stress-related managing skills, and overall well-being are assessed by standardized scales [Illness Behavior Questionnaire (IBQ); Coping Orientations to Problems Experienced (COPE); and Psychological General Well-Being Index (PGWBI)]. We conducted a qualitative analysis of the patient’s narration of his illness according to the procedure of the Grounded Theory. The MAXQDA software program was used to code the verbatim transcript.ResultsFrom the qualitative analysis of the interview, three thematic cores emerged: 1) the disease history; 2) the patient’s friendship with AD, a friend of his age diagnosed with NT1 since childhood; 3) the strategies used to deal with his symptoms before the diagnosis of NT1 and the related treatment. From the psychometric tests, the patient presents good coping strategies in dealing with stressful problems and events based mainly on acceptance and positive reinterpretation of the stressful situation.ConclusionThis case shows that comparing peers of the same age and suffering from the same illness improve the patient’s self-management ability to cope and live well with NT1.

Depression in Ménière's disease: a systematic review and meta-analysis.

Ménière's disease is a debilitating chronic peripheral vestibular disorder associated with psychiatric co-morbidities, notably depression. Database searches were performed to identify studies that assessed depression in Ménière's disease. Metrics used to diagnose depression were extracted, along with the prevalence of depression in each study. Fifteen studies from 8 different countries reported on 6587 patients. The weighted average age was 55.3 years (range, 21-88 years). Depression was measured by eight different scales, with Zung's Self-Rating Depression Scale used most often. A weighted proportion of 45.9 per cent of patients (confidence interval = 28.9-63.3) were depressed. Weighted averages (± standard deviations) of Beck's Depression Inventory and the Illness Behavior Questionnaire - Dysphoria were 8.5 ± 7.9 and 2.4 ± 1.7, respectively. The prevalence of depression in patients with Ménière's disease is nearly 50 per cent. Treating otolaryngologists should have a low threshold to screen and refer appropriately. Identifying and treating depression should allow for improvement of overall quality of life in patients with Ménière's disease.

A Comparative Study of Health Anxiety in Neurology and Psychiatry Settings.

Objectives Prevalence of health anxiety is highly varied based on different settings and samples studied. This study aimed to assess the prevalence of health anxiety among outpatients attending neurology and psychiatry outpatient setting in tertiary care hospital and understand the clinical correlates. Participants and Methods This was a cross-sectional study conducted in the outpatient settings including participants fulfilling study criteria. The assessments included semi-structured proforma for demographic and clinical details, general hypochondriasis subscale of Illness Behavior Questionnaire, and Short Health Anxiety Inventory. Data were collected in Epi-info and data analysis was done using STATA12. Results The health anxiety was reported to be 25% and 19% among psychiatry and neurology outpatients, respectively. Higher education level positively correlated with health anxiety. Skilled workers tend to have higher health anxiety than semiskilled workers. Patients with diagnosis of somatoform disorder and multiple diagnosis scored higher on health anxiety in both the settings. Conclusion Health anxiety appears to be common in psychiatry and neurology settings and needs further evaluation to understand its impact on consultation and health resource usages.

Personality traits, illness behaviors, and psychiatric comorbidity in individuals with psychogenic nonepileptic seizures (PNES), epilepsy, and other nonepileptic seizures (oNES): Differentiating between the conditions

ObjectivesThe study aimed to investigate if South African individuals with psychogenic nonepileptic seizures (PNES) differ from individuals with epileptic seizures (ES) and other nonepileptic seizures (oNES) in terms of demographic and seizure characteristics, personality traits, illness behaviors, and depression, anxiety, and posttraumatic stress disorder (PTSD) comorbidity in statistically significant ways; and if so, to test if these differences can be utilized in raising suspicion of PNES as the differential diagnosis to epilepsy and oNES in practice. MethodsData were analyzed from 29 adults with seizure complaints recruited using convenience sampling from a private and a government hospital with video-electroencephalography (vEEG) technology. A quantitative double-blind convenient sampling comparative design was used. A demographic and seizure questionnaire, the NEO Five Factor Inventory-3 (NEO-FFI-3), an abbreviated version of Illness Behavior Questionnaire (IBQ), and the Beck Anxiety Inventory — Primary Care (BAI-PC) were administered. Cronbach's alphas, analysis of variance (ANOVA), cross-tabulation, Fisher exact test, and receiver operating characteristic (ROC) analyses were performed on the dataset. ResultsThe total sample consisted of 29 participants, of which 5 had PNES (17%), 21 ES (73%), and 3 oNES (10%). The final sample was comprised of 24 participants from the private hospital and 5 from the government hospital. The group with PNES was found to be significantly more male, to experience significantly more monthly seizures, and chronic pain when comparing the PNES with the ES group, and the PNES with the combined ES and oNES group in both private only sample, as well as the private and government hospital combined sample. Patients with PNES also had a higher level of education compared with the group with ES in the combined private and government hospital sample, something that was not evident in the private hospital only sample. No significant differences between groups were found in either sample in terms of age, population group, language, age at first seizure, and the NEO-FFI-3 subscales. All three groups scored above the cutoff point of 5 exhibiting depression, anxiety, and PTSD symptoms on the BAI-PC in both samples. However, the group with PNES tended to score significantly higher than the group with ES and the combined ES and oNES group in the private hospital sample. A cutoff point of 12 on the BAI-PC was found to predict PNES in this seizure population with 80% sensitivity and 89% specificity. However, once the analysis was repeated on the combined private and government hospital sample, significance in BAI-PC scores between groups was lost. All scales showed good reliability in our study, with the exception of the “Openness to Experience” subscale of the NEO-FFI-3 once reliability analysis was carried out on the combined private and government hospital group. ConclusionsThis study provides an important stepping stone in the understanding of demographic and seizure factors, personality domains, abnormal illness behaviors, and psychiatric comorbidity in the South African population with PNES. The study also reported on a cutoff score of 12 on the BAI-PC predicting PNES with 80% sensitivity and 89% specificity in a private hospital sample.

Coping strategies in young and adult haemophilia patients: A tool for the adaptation to the disease.

Chronic diseases, after diagnosis, involve changes that have to favour coping with the new situation. The resources used will help control, manage and adapt to the disease. The psychological aspects may be influencing how the individual faces the situation. To assess whether perceptions or beliefs and illness behaviour influence the choice of coping strategies for young and adult patients with haemophilia. Multicenter cross-sectional descriptive study. We recruited 63 patients with haemophilia A and B, adolescents, young and adults, and both types of treatment. A clinical and sociodemographic data sheet, the Coping Strategies Inventory (CSI), the Illness Perception Questionnaire-revised (IPQ-R) and the Illness Behaviour Questionnaire (IBQ) were used. Patients with haemophilia use appropriate coping strategies, both cognitive and behavioural. Most of them are on-demand treatment, and despite arthropathy, they perceive good control of haemophilia. However, patients in prophylactic treatment are those employed more maladaptive coping strategies, less perception of control and hypochondriacal behaviour to the disease. The age variable may be relevant but we did not find significant differences. Coping strategies used by patients with haemophilia are adequate. Although it is noted that the perception of the disease, its controllability or not, affects illness behaviour and consequently how coping with haemophilia. These are based on personal characteristics, cognitive and attitudinal dispositions that the individual consciously use to solve or face adverse situations. The analysis of coping styles of patients could be a tool for professionals to manage properly the disease.

Patterns of Illness Behaviors and its Correlates in Patients with Chronic Nonorganic Pain.

Background:Illness behaviors if abnormal can have significant influence in presentations of chronic pain. The aim of the study was to derive the patterns of illness behaviors and its correlates in subjects with chronic nonorganic pain.Methods:Illness Behavior Questionnaire (IBQ) was administered to 301 adult individuals with chronic nonorganic pain. Factor analysis was performed on the IBQ, and relationships of the dimensions of illness behavior with clinical and demographic variables were computed.Results:Majority of the sample consisted of women (n = 208; 69%) with 43% from rural background and 58% from below poverty line status. Principal axis factoring resulted in four factors, namely health concerns, affective inhibition (AI), bodily distress, and affective distress with psychosocial problems. The three factors excluding AI had significant intercorrelation among them. There was significant difference in mean scores of factors, bodily distress and affective distress in patients from urban and rural background.Conclusions:Illness behaviors in chronic nonorganic pain can be understood as three interrelated factors-health concerns, affective distress with psychosocial problems, and bodily distress. AI might be an independent factor for presentation of chronic nonorganic pain.

Psychological Profile in Coronary Artery By-Pass Graft Patients vs. Valve Replacement Patients Entering Cardiac Rehabilitation after Surgery

Anxiety and depression are thought to influence the genesis of ischemic diseases and not of valvular diseases, but little is known on the psychological profile of cardiac patients after surgery. Aim of this study was to investigate differences in disease experience and mood between patients undergoing cardiac rehabilitation after coronary artery by-pass graft (CABG) or after valve replacement (VR). We studied 1,179 CABG and 737 VR patients who completed the Illness Behaviour Questionnaire and the Hospital Anxiety and Depression Scale after surgery. We tested the independent effect of the type of surgery by multivariate analysis and between-group differences in prevalence of clinically relevant scores. Relevant scores in the psychosomatic concern scale were more frequent in CABG than in VR patients. After correction by age, sex, education and marital status, scores of disease conviction and psychosomatic concern were higher in CABG patients, scores of denial were higher in VR patients. Unexpectedly, anxiety and depression scores did not differ between groups. Results suggest providing psychological support for anxiety and depression to both VR and CABG patients during cardiac rehabilitation, and planning differentiated interventions of cardiac rehabilitation and secondary prevention tailored to the specific psychological reactions of CABG and VR patients.

The behaviour and perception of illness: modulating variables of adherence in patients with haemophilia.

The recommended treatment in patients with severe haemophilia is prophylaxis. This prevents bleedings and reduces or delays the haemophilic arthropathy. Adherence defined as the follow-up of the patient to the prescriptions of the health professional to his treatment, both pharmacological and modifications in habits or stylelifes. Adherence rates in haemophilia are better than in other chronic diseases, but there remain reasons for nonadherence. The aim was to see if disease behaviour and disease perception together with coping strategies modulate adherence to treatment. Multicenter cross-sectional descriptive study. Patients recruited in Units of Hemophilia Hospitals and Regional Haemophilia Associations. Twenty-three patients participated The instruments used are as follows: data sheet, SF-36, A36 Hemophilia-Qol, Illness Perception Questionnaire-Revised (IPQ-R), Illness Behavior Questionnaire (IBQ) and Coping Strategies Inventory (CSI) and VERITAS-Pro. We found that 56% of patients with haemophilia are adherent. The most relevant clinical variables were hemarthrosis, diagnosis of arthropathy and presence of any coinfection, as well as family history, labour status and sociodemographic variables. Age was not a relevant variable in adherence. The worst adherence coincides with poorer quality of life and inadequate coping style. Nonadherent patients show greater conviction of disease, perception of cyclicity, more hypochondriacal behaviour towards the illness and perception concern about possible side effects of medication. Adherence in haemophilia requires a more experiential approach and individualized education. It is important that professionals take into account the patient's perception, behaviour and attitude towards the disease to achieve a better adaptation of their coping resources.

Multidimensional approach usefulness in early Alzheimer's disease: Advances in clinical practice.

Background and aim: Improving quality of life of patients with early Alzheimer’s Disease (AD) is a primary concern of health professionals involved in dementia treatment. The aim of this study is to reveal associations among psychiatric symptoms and wellbeing aspects, dysfunctional lifestyles and stress-related behaviors, illness perception, personality traits, and life quality satisfaction, in order to offer a comprehensive evaluation of psychological and behavioral aspects characterizing patients with early AD. Methods: This is a cross-sectional study in which all the outpatients included were evaluated at the Dementia Clinic in Parma (Italy). 21 patients with probable AD were assessed by an overall cognitive screening (Milan Overall Dementia Assessment), the evaluation of personal and instrumental autonomy (Activities of Daily Living and Instrumental Activities of Daily Living), and of dementia severity (Clinical Dementia Rating Scale). After the neurocognitive assessment, a wide battery of clinical and psychological measures (Symptom Questionnaire, Pisa Stress Questionnaire, Illness Behavior Questionnaire, Sixteen Personality Factor Questionnaire and Satisfaction Profile) was administered to the patients. Spearman’s rho correlations between clinical and psychological measures were performed. Results: A tendency to deny anxiety, depressive and somatic symptoms might be present in patients with early AD. They also present with hypochondriasis, resulting in higher level of anxiety and depression. Reduced liveliness and self-reliance as personality traits may influence the intensity of such symptoms. Conclusions: A comprehensive assessment including psychological and clinical measures should be routinely integrated in clinical practice for the evaluation of patients with early AD. (www.actabiomedica.it)

Effects of Pre-operative Psychological Status on Post-operative Recovery: A Prospective Study.

Often in clinical practice, a spectrum of outcomes from surgery may be observed ranging from a quick and comfortable recovery to a recovery punctuated by persistent pain and decreased quality of life. While there has been a fast pace of advances made in the field of operative surgery, surgeons seldom pay attention to factors such as the psychological profile of a patient that can affect recovery from surgery. To study the effects of pre-operative psychological profile on post-operative recovery in terms of pain, return to work and quality of life. Consecutive patients undergoing laparoscopic surgeries at Sagar Hospitals, Jayanagar, were recruited. All patients were assessed for psychological status using the screening for illness behaviour questionnaire (SIBQ) and pain catastrophizing scale (PCS). Following surgery, they were followed up for a period of 3months-on post-operative day 1, post-operative day 7, 1month and 3months from the date of surgery. Post-operative pain was measured using the visual analogue scale (Wong-Baker's), return to work was documented in days and quality of life was measured using the Short Form-36 version 2 (SF-36v2) Health Survey. The Pearson's correlation coefficients were used to compare variables with continuous data and Chi-square and Fisher's tests were used to test categorical data for significance. In a total of 98 patients recruited, 50 patients had a complete follow-up of 3months. Significant correlations existed between the pre-operative markers and markers of recovery. The Chi-square test and Fisher's exact tests showed significant differences in the scores of pre-operative markers between the groups of patients who developed chronic pain and those who did not. Difference in scores with regard to quality of life was also noted. Psychological status does play a role in post-operative recovery. This result opens up scope for counselling patients towards a healthy and comfortable recovery from surgery.