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Abstract(s)
Introdução: O doente hipocondríaco, segundo o Manual de Diagnóstico e Estatística
de Transtornos Mentais-4ª edição, é um indivíduo que tem uma crença inabalável de
possuir ou vir a desenvolver uma patologia grave. Com a atualização do “Manual de
Diagnóstico e Estatística de Transtornos Mentais-4ª edição”, para o “Manual de
Diagnóstico e Estatística de Transtornos Mentais-5ª edição”, a Hipocondria foi dividida
em “Distúrbio de Ansiedade da Doença”” e “Distúrbio do Sintoma Somático”,
observando-se, nos dois casos, elevados níveis de ansiedade relacionados com a saúde.
A maior diferença entre os dois distúrbios, é a presença de sintomas somáticos no
Distúrbio do Sintoma Somático, sendo que no Distúrbio de Ansiedade da Doença não
há sintomas somáticos, ou quando há, são de leve intensidade. Como tal, por ser uma
patologia subdiagnosticada e com alterações recentes na sua definição, é importante
que os médicos vão atualizando os seus conhecimentos acerca da Hipocondria,
verificando os critérios de diagnóstico recomendados, e fazendo um correto diagnóstico
diferencial e tratamento (é igualmente importante entender a postura e forma mais
correta de comunicar com o doente hipocondríaco). Com esta revisão bibliográfica,
pretende-se clarificar e esclarecer a forma mais correta de gerir um doente
hipocondríaco, desde o momento em que há uma suspeita diagnóstica de Hipocondria.
Métodos: A realização desta monografia baseou-se na leitura de artigos científicos.
Desta forma, usando os motores de busca “PubMed”, selecionei preferencialmente
artigos em inglês a partir do ano 2010 (contudo sem restrições de data de publicação),
usando múltiplas associações entre os termos “Hypochondriasis”, “Illness Anxiety
Disorder”, “Somatic Symptoms Disorder”, “Management”, “Diagnosis” e “Treatment”.
Usei também, livros de referência na área da Psiquiatria, nomeadamente o “Manual de
Diagnóstico e Estatística de Transtornos Mentais-4ª edição” e o “Manual de
Diagnóstico e Estatística de Transtornos Mentai-5ª edição”.
Conclusão: Foram já comprovados os benefícios, tanto dos Inibidores Seletivos da
Recaptação de Serotonina, como da Terapia Cognitivo-Comportamental, nos doentes
hipocondríacos, contudo continua a ser necessário a realização de mais estudos, para se
tornarem os tratamentos mais eficazes, sobretudo a longo prazo. Após a leitura de
vários artigos científicos relacionados com a Hipocondria, concluí que mais estudos
têm de ser efetuados para clarificar e tornar mais unânime o seu conceito.
Alguns autores defendem mesmo que, tanto o Distúrbio de Ansiedade da Doença, como
o Distúrbio do Sintoma Somático, deveriam ser considerados Transtornos de
Ansiedade, e não pertencerem à secção “Sintomas Somáticos e Distúrbios Relacionados”, mais uma prova da necessidade de continuar a clarificar o conceito de
Hipocondria.
Introduction: The hypochondriac patient, according to the “Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition”, is an individual who has an unwavering belief of possessing or developing a severe pathology. With the update of the “Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition” for “Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition”, the word hypochondriasis was divided into "Illness Anxiety Disorder" and "Somatic Symptom Disorder”, observing, both in one disorder and in the other, high health-related anxiety. The biggest difference between the two disorders is the presence of somatic symptoms in the Somatic Symptom Disorder, and in the Illness Anxiety Disorder there are no somatic symptoms, or when there are, are of mild intensity. As such, because it is an underdiagnosed pathology and with recent changes in the definition, it is important that doctors update their knowledge about Hypochondriasis, verifying the recommended diagnostic criteria, and making the right differential diagnoses and treatment (it is equally important to understand the posture and the most correct way to communicate with the hypochondriac patient). With this literature review, it is intended to clarify a correct way to manage a hypochondriac patient, from the moment there is a diagnostic suspicion of Hypochondriasis, to its treatment. Methods: This monograph was based on the reading of scientific articles. Thus, using the search engines "PubMed", I preferably selected articles in English from the year 2010 (however without restrictions of publication date), using multiple associations between the terms "Hypochondriasis", "Illness Anxiety Disorder", "Somatic Symptoms Disorder", "Management", "Diagnosis" and "Treatment". I also used reference books in psychiatry, namely the “Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition” and “Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition”. Results/Conclusion: The benefits of both Seletive Serotonin Reuptake Inhibitors and Cognitive-Behavioral Therapy in hypochondriac patients have already been proven, but further studies are still needed to become the most effective treatments, especially in the long term. After reading several scientific articles related to Hypochondriasis, more studies are required to clarify and make his concept more unanimous. Some authors even argue, that both Illness Anxiety Disorder and Somatic Symptoms Disorder, should be considered Anxiety Disorders, instead of being part of the section "Somatic Symptoms and Related Disorders", further proof of the need to clarify the concept of Hypochondriasis
Introduction: The hypochondriac patient, according to the “Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition”, is an individual who has an unwavering belief of possessing or developing a severe pathology. With the update of the “Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition” for “Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition”, the word hypochondriasis was divided into "Illness Anxiety Disorder" and "Somatic Symptom Disorder”, observing, both in one disorder and in the other, high health-related anxiety. The biggest difference between the two disorders is the presence of somatic symptoms in the Somatic Symptom Disorder, and in the Illness Anxiety Disorder there are no somatic symptoms, or when there are, are of mild intensity. As such, because it is an underdiagnosed pathology and with recent changes in the definition, it is important that doctors update their knowledge about Hypochondriasis, verifying the recommended diagnostic criteria, and making the right differential diagnoses and treatment (it is equally important to understand the posture and the most correct way to communicate with the hypochondriac patient). With this literature review, it is intended to clarify a correct way to manage a hypochondriac patient, from the moment there is a diagnostic suspicion of Hypochondriasis, to its treatment. Methods: This monograph was based on the reading of scientific articles. Thus, using the search engines "PubMed", I preferably selected articles in English from the year 2010 (however without restrictions of publication date), using multiple associations between the terms "Hypochondriasis", "Illness Anxiety Disorder", "Somatic Symptoms Disorder", "Management", "Diagnosis" and "Treatment". I also used reference books in psychiatry, namely the “Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition” and “Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition”. Results/Conclusion: The benefits of both Seletive Serotonin Reuptake Inhibitors and Cognitive-Behavioral Therapy in hypochondriac patients have already been proven, but further studies are still needed to become the most effective treatments, especially in the long term. After reading several scientific articles related to Hypochondriasis, more studies are required to clarify and make his concept more unanimous. Some authors even argue, that both Illness Anxiety Disorder and Somatic Symptoms Disorder, should be considered Anxiety Disorders, instead of being part of the section "Somatic Symptoms and Related Disorders", further proof of the need to clarify the concept of Hypochondriasis
Description
Keywords
Diagnóstico Distúrbio de Ansiedade da Doença Distúrbio do Sintoma
Somático Gestão Hipocondria Tratamento