Why health anxiety needs to be recognised in hospital practice, 2020, Tyrer

Andy

Andy

Retired committee member
Health anxiety, formerly part of hypochondriasis, but now reformulated as excessive concern about health and, by extension, illness, comprises a large proportion of consultations in hospital practice. For too long it has been ignored in practice and not formally treated. This belief is no longer tenable, and in the last few years a number of easily administered psychological treatments have shown consistent benefit that help patients, practitioners and planners of services. A stepped care approach in which physicians and nurses are first helped to identify health anxiety, explain its significance to patients and then, if necessary, administer these treatments in the clinical setting without referral to psychiatric services, is recommended as a way forward. This approach should be embraced in secondary care.
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Open access, https://www.rcpjournals.org/content/clinmedicine/20/3/339
 
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In my experience hospital staff have been excellent at "treating" my perceived health anxiety.

Having an easily visible and recognisable problem the staff, on realizing I had a diagnosis of ME/CFS, witheld treatment - even though it was obvious I was in a great deal of discomfort and getting worse- until they had an opportunity to berate me very, very loudly.

Given the state I was in I was too ill to do, or say, anything about it.

Since then I have had repeated close calls with the same thing. If it gets bad enough, quick enough and I am alone it could cause death. Even so, I have taken the chance & not attended A&E.

Perhaps there's a quota - when x number have died we'll be happy?

Is there any other profession or business in the world who whinge and find ways of abusing their customers simply because they're busy?
 
Invisible Woman said:
Having an easily visible and recognisable problem the staff, on realizing I had a diagnosis of ME/CFS, witheld treatment - even though it was obvious I was in a great deal of discomfort and getting worse- until they had an opportunity to berate me very, very loudly.
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This is why I don't go and see doctors unless my problem is actually visible. But, as you've found too, from experience I know that having a visible problem is no guarantee of getting appropriately treated or being treated with kindness or politeness.
 
This compares with other studies in which the proportion of all symptoms lacking a medical explanation is nearer to 50%.
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Reference for the above :

Nimnuan C, Hotopf M, Wessely S. Medically unexplained symptoms: an epidemiological study in seven specialities. J Psychosom Res 2001;51:361–7.

Is this reference the same one that @dave30th has debunked on several occasions?
 
wdb said:
My biggest health anxiety is that some idiot doctor might diagnose me with health anxiety thus preventing access to appropriate services.
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YES!
this is also true when you already do have anxiety and it’s on your doctors/ hospitals notes and also sometimes clearly visible, so because of that they think everything is down to anxiety. So tired of being gas lighted.
 
What? It's literally a reflex that is often done-and-gone in a few minutes. There's literally an entire field of published literature on this being a systemic problem with well-documented disastrous consequences. We are currently living in the golden age of psychosomatics, it's never been more popular and influential. And no one has ever been able to demonstrate any ability to tell "health anxiety", whatever that means, apart from illness. Doctors are not psychics, they need the tools and processes of science to validate their judgment.

Great example of ivory tower bubble, to suggest that something should be done when in fact it has been abused to hell and back for centuries and should rather be deleted from the profession. It makes as much sense as someone suggesting maybe there should be criminal penalties for drug use as a deterrent as if no one had ever thought of this before. It only shows you've been living in a fantasy bubble.
 
Arnie Pye said:
Is this reference the same one that @dave30th has debunked on several occasions?
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Not so much debunked as wildly misleading in the first place. Every symptom is unexplained until it is and diagnosis is neither easy nor straightforward. Medical science is so far from being complete that to argue that anything that can't be readily explained in a few seconds cannot exist is unscientific nonsense.

Most crimes are also unexplained until they are eventually investigated. Most crimes are not investigated simply because the resources aren't there. Those crimes still happened and the victims are still affected, sometimes severely so. This logic is frankly absurd to the point of being infantile.
 
Wow, that's a heckuva patronising and downright potentially dangerous set of personal beliefs on display in that article. I wondered who this person was and a quick google turned this up (apologies if everyone here knows who he is, I hadn't heard of him): https://www.imperial.ac.uk/people/p.tyrer . "Professor of Community Psychiatry in the Centre for Mental Health in the Division of Experimental Medicine." Experimental Medicine, eh?

Apparently he wants to generate work for himself via his belief that more folks have mental illnesses than is currently recognised:
Much of his recent work has been concerned with improving and extending the concept of personality disorder. Personality disturbance is very common, not just in psychiatric practice, and this importance has been largely unrecognised as the classification system for this group of disorders is so poor. Fortunately, a major reform of classification is under way and will both simplify, and, we hope, destigmatise a very common form of mental distress.
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the only reform needed is to throw their bible the dsm into the bin where it has always belonged if I was in charge of public libraries who by law have to have copies of various psychobabble publications they would always be placed in works of fiction . as far as I am aware libraries do not have sections called idiocies of the past perhaps such a section will one day be created .
 
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