Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-24T07:12:51.100Z Has data issue: false hasContentIssue false
  • English
  • Français

The diagnostic and prognostic significance of the Whitely Index, the Illness Attitude Scales and the Somatosensory Amplification Scale

Published online by Cambridge University Press:  09 July 2009

A. E. M. Speckens ,
A. M. Van Hemert ,
P. Spinhoven  and
J. H. Bolk
A. E. M. Speckens*
Affiliation:
Department of Psychiatry and Department of General Medicine, University Hospital Leiden, The Netherlands
A. M. Van Hemert
Affiliation:
Department of Psychiatry and Department of General Medicine, University Hospital Leiden, The Netherlands
P. Spinhoven
Affiliation:
Department of Psychiatry and Department of General Medicine, University Hospital Leiden, The Netherlands
J. H. Bolk
Affiliation:
Department of Psychiatry and Department of General Medicine, University Hospital Leiden, The Netherlands
*
1Address for correspondence: Dr Anne E. M. Speckens Department of PsychiatryB1-P. Leiden University HospitalPostbox 96002300 RC LeidenThe Netherlands.
Get access Rights & Permissions [Opens in a new window]

Synopsis

The aim of this study was to assess the ability of the Whitely Index, Illness Attitude Scales and Somatosensory Amplification Scale to differentiate in patients with medically unexplained physical symptoms between hypochondriacal and non-hypochondriacal patients and to examine whether the scores on these questionnaires are predictive of long-term outcome in terms of recovery of presenting symptoms and number of visits to the general practitioner. The study population consisted of 183 consecutive patients, who presented with medically unexplained physical symptoms to a general medical out-patient clinic. The Health Anxiety subscale of the Illness Attitude Scales and the Whitely Index were best in discriminating between hypochondriacal and non-hypochondriacal patients. The sensitivity and specificity of the Health Anxiety subscale of the Illness Attitude Scales were 79% and 84%, and of the Whitely Index 87% and 72%. The Whitely Index was negatively associated with recovery rate at 1 year follow-up. The Illness Behaviour subscale of the Illness Attitude Scales appeared to be predictive of the number of visits to the general practitioner. These findings might have clinical implications in helping to distinguish in patients with medically unexplained symptoms those for whom there is a high chance of persistence of the symptoms and/or of high medical care utilization.

Type
Brief Communication
Information
Psychological Medicine , Volume 26 , Issue 5 , September 1996 , pp. 1085 - 1090
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barsky, A. J., Wyshak, G. & Klerman, G. L. (1986). Medical and psychiatric determinants of outpatient medical utilization. Medical Care 24, 548–560.CrossRefGoogle ScholarPubMed
Barsky, A. J., Goodson, J. D., Lane, R. S. & Cleary, P. D. (1988). The amplification of somatic symptoms. Psychosomatic Medicine 50, 510–519.CrossRefGoogle ScholarPubMed
Barsky, A. J., Wyshak, G. & Klerman, G. L. (1990 a). The Somatosensory Amplification Scale and its relationship to hypochondriasis. Journal of Psychiatric Research 4, 323–334.CrossRefGoogle Scholar
Barsky, A. J., Wyshak, G., Klerman, G. L. & Latham, K. S. (1990 b). The prevalence of hypochondriasis in medical outpatients. Social Psychiatry and Psychiatric Epidemiology 25, 89–94.CrossRefGoogle ScholarPubMed
Barsky, A. J., Cleary, P. D., Wyshak, G., Spitzer, R. L., Williams, J. B. W. & Klerman, G. L. (1992). A stuctured diagnostic interview for hypochondriasis. A proposed criterion standard. Journal of Nervious and Mental Disease 180, 20–27.CrossRefGoogle Scholar
Beaber, R. J. & Rodney, W. M. (1984). Underdiagnosis of hypochondriasis in family practice. Psychosomatics 25, 39–46.CrossRefGoogle ScholarPubMed
Cleary, P. D., Bush, B. T. & Kessler, L. G. (1987). Evaluating the use of mental health screening scales in primary care settings using receiver operating characteristics curves. Medical Care 25 (Suppl), S90–S98.CrossRefGoogle Scholar
Goldberg, D. (1972). The Detection of Psychiatric Illness by Questionnaire. Oxford University Press: London.Google Scholar
Kellner, R. (1986). Illness Attitude Scales. In Somatization and Hypochondriasis, pp. 319–324. Praeger Publishers: New York.Google Scholar
Kellner, R., Abbott, P., Pathak, D., Winslow, W. W. & Umland, B. E. (1983–1984). Hypochondriacal beliefs and attitudes in family practice and psychiatric patients. International Journal of Psychiatry in Medicine 13, 127–139.CrossRefGoogle ScholarPubMed
Kellner, R., Abbott, P., Winslow, W. W. & Pathak, D. (1987). Fears, beliefs, and attitudes in DSM-III hypochondriasis. Journal of Nervous and Mental Disease 175, 20–25.Google Scholar
Pilowsky, I. (1967). Dimensions of hypochondriasis. British Journal of Psychiatry 113, 89–93.Google Scholar
Sackett, D. L., Haynes, R. B., Guyatt, G. H. & Tugwell, P. (eds.) (1991). The interpretation of diagnostic data. In Clinical Epidemiology: A Basic Science for Clinical Medicine, pp. 69–152. Little, Brown & Company: Boston.Google Scholar
Speckens, A. E. M., Van Hemert, A. M., Spinhoven, Ph., Hawton, K. E., Bolk, J. H. & Rooijmans, H. G. M. (1995). Cognitive behavioural therapy for medically unexplained physical symptoms: a randomized controlled trial. British Medical Journal 311, 1328–1332.CrossRefGoogle Scholar
Speckens, A. E. M., Van Hemert, A. M., Spinhoven, Ph. & Bolk, J. H. (1996). A validation study of the Whitely Index, Illness Attitude Scales and Somatosensory Amplification Scale in general medical outpatients and general practice patients. Journal of Psychosomatic Research (in the press).CrossRefGoogle Scholar
Van Hemert, A. M., Hengeveld, M. W., Bolk, J. H., Rooijmans, H. G. M. & Vandenbroucke, J. P. (1993). Psychiatric disorders in relation to medical illness among patients of a general medical outpatient clinic. Psychological Medicine 23, 167–173.CrossRefGoogle Scholar
Van Hemert, A. M., Den Heijer, M., Vorstenbosch, M. & Bolk, J. H. (1995). Detecting psychiatric disorders in medical practice using the General Health Questionnaire: why do cut-off levels vary? Psychological Medicine 25, 165–170.CrossRefGoogle Scholar