Thesis (doctoral)--Lund University, 1998. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (doctoral)--Lund University, 1998. / Added t.p. with thesis statement inserted. Includes bibliographical references.

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

Thesis (M.A. (Clinical Psychology))--University of Pretoria, 2003.

Thesis (M.S.)--University of North Carolina at Wilmington, 2006. / Includes bibliographical references (leaves: [43]-47)

Abstract The aim of this cross-sectional controlled study was to determine frequent attenders' chronic diseases and their reasons for encounter in primary health care. Furthermore, the study aimed to determine the associations of social, psychological and family factors with frequent attendance in a Finnish health centre. Patients who made eight or more annual visits to physicians in the health centre during one year were defined as frequent attenders (FA). All the FAs during 1994 (N=304) and 304 randomly selected age- and sex-matched controls constituted the study population. The data were collected from annual statistics, medical records and postal questionnaires. Over one third of the study population was interviewed. International Classification of Primary Care (ICPC) was used to determine the reasons for encounter and Symptom Checklist - 36 (SCL-36) to assess the psychological distress. Toronto Alexithymia Scale -20 (TAS-20) was used as a measure of alexithymia and Whiteley Index (WI) to determine hypochondriacal beliefs. The results showed that 4.7% of the whole population aged 15 years or older in Oulainen were FAs. They accounted for 23.5% of all visits made within the respective age group. The mean age of the FAs was 49.8 years. Over two thirds of them were female. The FAs had lower basic education and occupational status than the controls. The FAs visited physicians in the health centre mostly for reasons related to the musculoskeletal, respiratory and digestive systems. There appeared to be more chronic diseases among the FAs than among the controls. The FAs had over three times more mental disorders than the controls. The interviewed FAs had significantly more psychological distress, somatization and hypochondriacal beliefs than the controls. The risk of frequent attendance was higher in the older family life cycle phases than in the younger family life cycle phases. Multivariate analyses showed chronic somatic disease and hypochondriacal beliefs to be risk factors for frequent attendance. Concurrence of somatization and hypochondriacal beliefs increased the risk to be a FA. As a conclusion, the results emphasize the need to consider the FAs' own bodily concerns expressed as hypochondriacal beliefs when managing them. Furthermore, the study implicates a need to integrate the biomedical, psychological and social dimensions in the care of FAs in primary health care.

Sixteen couples in which one of the partners met criteria for Somatoform Disorder or Undifferentiated Somatoform Disorder as determined by the SOMS and who scored less than or equal to 101 on the Dyadic Adjustment Scale participated in this study. These couples were randomly assigned to 8 sessions of emotionally focused therapy or to a 12-week wait list condition. The purpose of the study was to investigate the effectiveness of emotion focused therapy as a treatment of somatoform disorders. Results suggest that the intervention of emotion focused couples therapy (EFT) was not effective in the treatment of somatoform disorders. A significant effect (.023) was found in the increased reporting of symptoms at posttest. Implications for EFT and marriage and family therapy are discussed. / Ph. D.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Munchausen syndrome is a rare condition in which the patient repeatedly seeks medical care for factitious illnesses. Cardiac Munchausen syndrome was first reported in 1953 and later referred to as cardiopathia fantastica. It is characterized by clinical manifestations of acute cardiac disease that are feigned and recurrent. Cardiopathia fantastica can have a variety of presentations similar to true cardiac disease. Most cases have presented with chest pain simulating acute coronary artery disease, but arrhythmias, hypertensive crises, abnormal biochemistry, and electrocardiographic findings have also been noted. These patients are willing to undergo expensive, invasive, and risky procedures to evaluate their simulated illness. This condition is likely to be significantly underreported. In some patients, the presence of abnormal findings that are clinically insignificant may complicate the investigative approach. Patients with this disorder consume a disproportionate amount of health care dollars and sometimes are left with residual deficits as complications of invasive procedures. In this review, we discuss the recognition, manifestations, and treatment of cardiopathia fantastica.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 6 uppsatser.