Health anxiety and illness worry

مِن شَرِّ ٱلۡوَسۡوَاسِ ٱلۡخَنَّاسِ

against the harm of the slinking whisperer––

لَّيۡسَ عَلَى ٱلضُّعَفَآءِ وَلَا عَلَى ٱلۡمَرۡضَىٰ وَلَا عَلَى ٱلَّذِينَ لَا يَجِدُونَ مَا يُنفِقُونَ حَرَجٌ إِذَا نَصَحُواْ لِلَّهِ وَرَسُولِهِۦۚ مَا عَلَى ٱلۡمُحۡسِنِينَ مِن سَبِيلࣲۚ وَٱللَّهُ غَفُورࣱ رَّحِيمࣱ‏

but there is no blame attached to the weak, the sick, and those who have no means to spend, provided they are true to God and His Messenger- there is no reason to reproach those who do good: God is most forgiving and merciful

وَلۡيَسۡتَعۡفِفِ ٱلَّذِينَ لَا يَجِدُونَ نِكَاحًا حَتَّىٰ يُغۡنِيَهُمُ ٱللَّهُ مِن فَضۡلِهِۦۗ وَٱلَّذِينَ يَبۡتَغُونَ ٱلۡكِتَٰبَ مِمَّا مَلَكَتۡ أَيۡمَٰنُكُمۡ فَكَاتِبُوهُمۡ إِنۡ عَلِمۡتُمۡ فِيهِمۡ خَيۡرࣰ اۖ وَءَاتُوهُم مِّن مَّالِ ٱللَّهِ ٱلَّذِيٓ ءَاتَىٰكُمۡۚ وَلَا تُكۡرِهُواْ فَتَيَٰتِكُمۡ عَلَى ٱلۡبِغَآءِ إِنۡ أَرَدۡنَ تَحَصُّنࣰ ا لِّتَبۡتَغُواْ عَرَضَ ٱلۡحَيَوٰةِ ٱلدُّنۡيَاۚ وَمَن يُكۡرِههُّنَّ فَإِنَّ ٱللَّهَ مِنۢ بَعۡدِ إِكۡرَٰهِهِنَّ غَفُورࣱ رَّحِيمࣱ‏

Those who are unable to marry should keep chaste until God gives them enough out of His bounty. If any of your slaves wish to pay for their freedom, make a contract with them accordingly, if you know they have good in them, and give them some of the wealth God has given you. Do not force your slave-girls into prostitution, when they themselves wish to remain honourable, in your quest for the short-term gains of this world, although, if they are forced, God will be forgiving and merciful to them

وَلِكُلࣲّ جَعَلۡنَا مَوَٰلِيَ مِمَّا تَرَكَ ٱلۡوَٰلِدَانِ وَٱلۡأَقۡرَبُونَۚ وَٱلَّذِينَ عَقَدَتۡ أَيۡمَٰنُكُمۡ فَـَٔاتُوهُمۡ نَصِيبَهُمۡۚ إِنَّ ٱللَّهَ كَانَ عَلَىٰ كُلِّ شَيۡءࣲ شَهِيدًا

We have appointed heirs for everything that parents and close relatives leave behind, including those to whom you have pledged your hands [in marriage], so give them their share: God is witness to everything

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُوٓاْ إِذَا جَآءَكُمُ ٱلۡمُؤۡمِنَٰتُ مُهَٰجِرَٰتࣲ فَٱمۡتَحِنُوهُنَّۖ ٱللَّهُ أَعۡلَمُ بِإِيمَٰنِهِنَّۖ فَإِنۡ عَلِمۡتُمُوهُنَّ مُؤۡمِنَٰتࣲ فَلَا تَرۡجِعُوهُنَّ إِلَى ٱلۡكُفَّارِۖ لَا هُنَّ حِلࣱّ لَّهُمۡ وَلَا هُمۡ يَحِلُّونَ لَهُنَّۖ وَءَاتُوهُم مَّآ أَنفَقُواْۚ وَلَا جُنَاحَ عَلَيۡكُمۡ أَن تَنكِحُوهُنَّ إِذَآ ءَاتَيۡتُمُوهُنَّ أُجُورَهُنَّۚ وَلَا تُمۡسِكُواْ بِعِصَمِ ٱلۡكَوَافِرِ وَسۡـَٔلُواْ مَآ أَنفَقۡتُمۡ وَلۡيَسۡـَٔلُواْ مَآ أَنفَقُواْۚ ذَٰلِكُمۡ حُكۡمُ ٱللَّهِ يَحۡكُمُ بَيۡنَكُمۡۖ وَٱللَّهُ عَلِيمٌ حَكِيمࣱ‏

You who believe, test the believing women when they come to you as emigrants- God knows best about their faith- and if you are sure of their belief, do not send them back to the disbelievers: they are not lawful wives for them, nor are the disbelievers their lawful husbands. Give the disbelievers whatever bride-gifts they have paid- if you choose to marry them, there is no blame on you once you have paid their bride-gifts- and do not yourselves hold on to marriage ties with disbelieving women. Ask for repayment of the bride-gifts you have paid, and let the disbelievers do the same. This is God’s judgement: He judges between you, God is all knowing and wise

فَإِذَا جَآءَتۡهُمُ ٱلۡحَسَنَةُ قَالُواْ لَنَا هَٰذِهِۦۖ وَإِن تُصِبۡهُمۡ سَيِّئَةࣱ يَطَّيَّرُواْ بِمُوسَىٰ وَمَن مَّعَهُۥٓۗ أَلَآ إِنَّمَا طَٰٓئِرُهُمۡ عِندَ ٱللَّهِ وَلَٰكِنَّ أَكۡثَرَهُمۡ لَا يَعۡلَمُونَ

then, when something good came their way, they said, ‘This is our due!’. When something bad came, they ascribed it to the evil omen of Moses and those with him, but their ‘evil omen’ was really from God, though most of them did not realize it

(And such of your slaves as seek a writing (of emancipation), write it for them�) [24:33]. This verse was revealed about a slave of Huwaytib ibn �Abd al-�Uzza who was called Subayh. The latter asked his master for a writing of emancipation but he refused. When Allah, exalted is He, revealed this verse, Huwaytib agreed to write a letter of emancipation in exchange for a hundred pieces of gold. Out of this sum, he offered him twenty pieces of gold which he paid. But he was killed in war at the Battle of Hunayn. (Force not your slave-girls to whoredom that ye may seek enjoyment of the life of the world, if they would preserve their chastity) [24:33]. Ahmad ibn al-Hasan al-Qadi informed us> the chamberlain of Ahmad al-Tusi> Muhammad ibn Hamdan> Abu Mu�awiyah> al-A�mash> Abu Sufyan> Jabir who said: ��Abd Allah ibn Ubayy used to say to a slave-girl of his: �Go and earn something for us from wh

(And unto each We have appointed heirs and near kindred �) [4:33]. Abu �Abd Allah Muhammad ibn �Abd Allah al-Farisi informed us> Muhammad ibn �Abd Allah ibn Hamawayh al-Harawi> �Ali ibn Muhammad al-Khuza�i> Abu�l-Yaman al-Hakam ibn Nafi�> Shu�ayb ibn Abi Hamzah> al-Zuhri> Sa�id ibn al-Musayyab who said: �The verse (And unto each We have appointed heirs) was revealed about those who used to adopt men who were not their natural sons and then make them inherit from them. Allah, exalted is He, revealed about them that something should be apportioned for them in the bequest while the division of estate He specifically allocated for the heirs who were immediate family relatives or close relatives. He denied a share of the estate to those who were adopted and, instead, allowed them to have a portion of the bequest�.

(O ye who believe! When believing women come unto you as fugitives, examine them. Allah is Best Aware of their faith�) [60:10]. Ibn �Abbas said: �On the year of Hudaybiyyah, the idolaters of Mecca signed a peace treaty with the Messenger of Allah, Allah bless him and give him peace. This treaty stipulated that whoever of the people of Mecca runs away to him from them should be returned to them, and whoever of his Companions runs away to the people of Mecca will not be returned. They wrote the treaty and sealed it. Just after signing the treaty, Subay�ah bint al-Harith al-Aslamiyyah went to the Prophet, Allah bless him and give him peace, while he was still at al-Hudaybiyyah. Her husband, who was an unbeliever came and said: �O Muhammad, return my wife to me, for you had agreed to return to us whoever runs away to you. The ink of the treaty has not dried yet�. Allah, exalted is He, then r

from the evil of the slinking whisperer Satan — he is referred to by the name of the action waswasa on account of his repeated engaging in it — who slinks away and recoils from the heart whenever God is mentioned

As for the weak such as the old and the sick the blind and the chronically ill and those who find nothing to expend for the struggle no blame no sin falls upon them should they stay away from it if they remain true to God and to His Messenger when they stay behind by not spreading false rumours or impeding others from joining the struggle but by adhering to obedience. There is no way of blame no way of reproach against those who are virtuous through such behaviour. And God is Forgiving Merciful to them by granting them such leeway in this matter.

There is no blame on those who are weak or ill or who find no resources to spend, if they are sincere and true (in duty) to Allah and His Messenger. No means (of complaint) can there be against the doers of good. And Allah is Oft-Forgiving, Most Merciful (91)Nor (is there blame) on those who came to you to be provided with mounts, when you said: "I can find no mounts for you," they turned back, with their eyes overflowing with tears of grief that they could not find anything to spend (92)The means (of complaint) is only against those who are rich, and yet ask exemption. They are content to be with (the women) who sit behind (at home) and Allah has sealed up their hearts so that they know not (what they are losing)(93) Legitimate Excuses for staying away from Jihad Allah mentions here the valid excuses that permit one to stay away from fighting. He first mentions the excuses that remain

حَدَّثَنِي عَبْدُ اللَّهِ بْنُ مُحَمَّدٍ، حَدَّثَنَا عَبْدُ الْمَلِكِ بْنُ عَمْرٍو، حَدَّثَنَا زُهَيْرُ بْنُ مُحَمَّدٍ، عَنْ مُحَمَّدِ بْنِ عَمْرِو بْنِ حَلْحَلَةَ، عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي سَعِيدٍ الْخُدْرِيِّ، وَعَنْ أَبِي هُرَيْرَةَ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏ "‏ مَا يُصِيبُ الْمُسْلِمَ مِنْ نَصَبٍ وَلاَ وَصَبٍ وَلاَ هَمٍّ وَلاَ حُزْنٍ وَلاَ أَذًى وَلاَ غَمٍّ حَتَّى الشَّوْكَةِ يُشَاكُهَا، إِلاَّ كَفَّرَ اللَّهُ بِهَا مِنْ خَطَايَاهُ ‏"‏‏.‏

Narrated Abu Sa`id Al-Khudri and Abu Huraira:The Prophet (ﷺ) said, "No fatigue, nor disease, nor sorrow, nor sadness, nor hurt, nor distress befalls a Muslim, even if it were the prick he receives from a thorn, but that Allah expiates some of his sins for that

حَدَّثَنَا إِبْرَاهِيمُ بْنُ الْمُنْذِرِ، قَالَ حَدَّثَنِي مُحَمَّدُ بْنُ فُلَيْحٍ، قَالَ حَدَّثَنِي أَبِي، عَنْ هِلاَلِ بْنِ عَلِيٍّ، مِنْ بَنِي عَامِرِ بْنِ لُؤَىٍّ عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي هُرَيْرَةَ ـ رضى الله عنه ـ قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ مَثَلُ الْمُؤْمِنِ كَمَثَلِ الْخَامَةِ مِنَ الزَّرْعِ مِنْ حَيْثُ أَتَتْهَا الرِّيحُ كَفَأَتْهَا، فَإِذَا اعْتَدَلَتْ تَكَفَّأُ بِالْبَلاَءِ، وَالْفَاجِرُ كَالأَرْزَةِ صَمَّاءَ مُعْتَدِلَةً حَتَّى يَقْصِمَهَا اللَّهُ إِذَا شَاءَ ‏"‏‏.‏

Narrated Abu Huraira:Allah's Messenger (ﷺ) said, "The example of a believer is that of a fresh tender plant; from whatever direction the wind comes, it bends it, but when the wind becomes quiet, it becomes straight again. Similarly, a believer is afflicted with calamities (but he remains patient till Allah removes his difficulties.) And an impious wicked person is like a pine tree which keeps hard and straight till Allah cuts (breaks) it down when He wishes." (See Hadith No. 558, Vol)

حَدَّثَنَا مُحَمَّدُ بْنُ يَحْيَى، قال حَدَّثَنَا إِسْحَاقُ بْنُ مُحَمَّدٍ الْفَرْوِيُّ، قال حَدَّثَنَا إِسْمَاعِيلُ بْنُ جَعْفَرٍ، عَنْ عُمَارَةَ بْنِ غَزِيَّةَ، عَنْ عَاصِمِ بْنِ عُمَرَ بْنِ قَتَادَةَ، عَنْ مَحْمُودِ بْنِ لَبِيدٍ، عَنْ قَتَادَةَ بْنِ النُّعْمَانِ، أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم قَالَ ‏ "‏ إِذَا أَحَبَّ اللَّهُ عَبْدًا حَمَاهُ الدُّنْيَا كَمَا يَظَلُّ أَحَدُكُمْ يَحْمِي سَقِيمَهُ الْمَاءَ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى وَفِي الْبَابِ عَنْ صُهَيْبٍ وَأُمِّ الْمُنْذِرِ ‏.‏ وَهَذَا حَدِيثٌ حَسَنٌ غَرِيبٌ ‏.‏ وَقَدْ رُوِيَ هَذَا الْحَدِيثُ عَنْ مَحْمُودِ بْنِ لَبِيدٍ عَنِ النَّبِيِّ صلى الله عليه وسلم مُرْسَلاً ‏.‏ حَدَّثَنَا عَلِيُّ بْنُ حُجْرٍ، قال أَخْبَرَنَا إِسْمَاعِيلُ بْنُ جَعْفَرٍ، عَنْ عَمْرِو بْنِ أَبِي عَمْرٍو، عَنْ عَاصِمِ بْنِ عُمَرَ بْنِ قَتَادَةَ، عَنْ مَحْمُودِ بْنِ لَبِيدٍ، عَنِ النَّبِيِّ صلى الله عليه وسلم نَحْوَهُ وَلَمْ يَذْكُرْ فِيهِ عَنْ قَتَادَةَ بْنِ النُّعْمَانِ ‏.‏ قَالَ أَبُو عِيسَى وَقَتَادَةُ بْنُ النُّعْمَانِ الظَّفَرِيُّ هُوَ أَخُو أَبِي سَعِيدٍ الْخُدْرِيِّ لأُمِّهِ وَمَحْمُودُ بْنُ لَبِيدٍ قَدْ أَدْرَكَ النَّبِيَّ صلى الله عليه وسلم وَرَآهُ وَهُوَ غُلاَمٌ صَغِيرٌ ‏.‏

Qatadah bin An-Nu'man narrated that the Messenger of Allah (s.a.w) said:"When Allah loves a slave, He prevents him from the world, just as one of you prevents his sick from water." Another chain reports a similar narration

حَدَّثَنَا عَبَّاسُ بْنُ مُحَمَّدٍ الدُّورِيُّ، قال حَدَّثَنَا يُونُسُ بْنُ مُحَمَّدٍ، قال حَدَّثَنَا فُلَيْحُ بْنُ سُلَيْمَانَ، عَنْ عُثْمَانَ بْنِ عَبْدِ الرَّحْمَنِ التَّيْمِيِّ، عَنْ يَعْقُوبَ بْنِ أَبِي يَعْقُوبَ، عَنْ أُمِّ الْمُنْذِرِ، قَالَتْ دَخَلَ عَلَىَّ رَسُولُ اللَّهِ صلى الله عليه وسلم وَمَعَهُ عَلِيٌّ وَلَنَا دَوَالٍ مُعَلَّقَةٌ قَالَتْ فَجَعَلَ رَسُولُ اللَّهِ صلى الله عليه وسلم يَأْكُلُ وَعَلِيٌّ مَعَهُ يَأْكُلُ ‏.‏ فَقَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم لِعَلِيٍّ ‏"‏ مَهْ مَهْ يَا عَلِيُّ فَإِنَّكَ نَاقِهٌ ‏"‏ ‏.‏ قَالَ فَجَلَسَ عَلِيٌّ وَالنَّبِيُّ صلى الله عليه وسلم يَأْكُلُ ‏.‏ قَالَتْ فَجَعَلْتُ لَهُمْ سِلْقًا وَشَعِيرًا فَقَالَ النَّبِيُّ صلى الله عليه وسلم ‏"‏ يَا عَلِيُّ مِنْ هَذَا فَأَصِبْ فَإِنَّهُ أَوْفَقُ لَكَ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ غَرِيبٌ لاَ نَعْرِفُهُ إِلاَّ مِنْ حَدِيثِ فُلَيْحٍ ‏.‏ وَيُرْوَى عَنْ فُلَيْحٍ عَنْ أَيُّوبَ بْنِ عَبْدِ الرَّحْمَنِ ‏.‏ حَدَّثَنَا مُحَمَّدُ بْنُ بَشَّارٍ، قال حَدَّثَنَا أَبُو عَامِرٍ، وَأَبُو دَاوُدَ قَالاَ حَدَّثَنَا فُلَيْحُ بْنُ سُلَيْمَانَ، عَنْ أَيُّوبَ بْنِ عَبْدِ الرَّحْمَنِ، عَنْ يَعْقُوبَ، عَنْ أُمِّ الْمُنْذِرِ الأَنْصَارِيَّةِ، فِي حَدِيثِهِ قَالَتْ دَخَلَ عَلَيْنَا رَسُولُ اللَّهِ صلى الله عليه وسلم فَذَكَرَ نَحْوَ حَدِيثِ يُونُسَ بْنِ مُحَمَّدٍ إِلاَّ أَنَّهُ قَالَ ‏"‏ أَنْفَعُ لَكَ ‏"‏ ‏.‏ وَقَالَ مُحَمَّدُ بْنُ بَشَّارٍ وَحَدَّثَنِيهِ أَيُّوبُ بْنُ عَبْدِ الرَّحْمَنِ ‏.‏ هَذَا حَدِيثٌ جَيِّدٌ غَرِيبٌ ‏.‏

Umm Al-Mundhir said:"The Messenger of Allah (ﷺ) entered upon me, while `Ali was with him, and we had a cluster of unripe dates hanging." She said: "The Messenger of Allah (ﷺ) began eating, and `Ali ate with him. The Messenger of Allah (ﷺ) said to `Ali: 'Stop, stop, for you are still recovering.' So `Ali sat and the Prophet (ﷺ) ate." She said: "I made some chard and barley for them, so the Prophet (ﷺ) said: 'O `Ali eat from this, for indeed it will be more suitable for you." Another chain reports a similar narration

أما ما ذكرتم من أن النبي كان يعجبه الفأل الحسن فلا ريب في ثبوت ذلك عنه وقد قرن ذلك بإبطال الطيرة كما في الصحيحين من حديث الزهري عن عبيد بن عبدالله عن أبى هريرة رضى الله عنه قال قال رسول الله صلى عليه وسلم لاطيرة وخيرها الفأل قالوا وما الفأل يا رسول الله قال الكلمة الصالحة يسمعها أحدكم فابتدأهم النبي بإزالة الشبهة وأبطال الطيرة لئلا يتوهموها عليه في إعجابه بالفأل الصالح وليس في الإعجاب بالفأل ومحبته شىء من الشرك بل ذلك إبانة عن مقتضى الطبيعة وموجب الفطرة الإنسانية التي تميل إلى مايلائمها ويوافقها مما ينفعها كما أخبرهم أنه حبب إليه من الدنيا النساء والطيب 00

وقد قال رسول الله إذا كان بالبلد الذي أنتم فيه فلا تخرجوا منه وقال إن كان ببلد فلا تدخلوه يريد بقوله لا تخرجوا من البلد أذا كان فيه كأنكم تظنون أن الفرار من قدر الله ينجيكم من الله ويريد إن كان ببلد فلا تدخلوه فإن مقامكم في الموضع الذي لا طاعون فيه أسكن لأنفسكم وأطيب لمعيشتكم ومن ذلك المرأة تعرف بالشؤم والدار فينال الرجل مكروه أو جائحة فيقول أعدتني بشؤمها فهذا هو العدوى الذي قال فيه رسول الله لا عدوى فأما الحديث الذي رواه أبو هريرة رضى الله عنه أنه قال الشؤم في المرأة والدار والدابة فإن هذا الحديث يتوهم فيه الغلط على أبى هريرة وأنه سمع فيه شيئا من رسول الله فلم يعه حدثني محمد بن القطعي حدثنا عبد الأعلى عن سعيد عن قتادة عن أبى حسان الأعرج أن رجلين دخلا على عائشة فقالا إن أبا هريرة رضى الله عنه يحدث عن رسول الله أنه قال إنما الطيرة في المرأة والدار والدابة فطارت شفقا ثم قالت كذب والذي أنزل الفرقان على أبى القاسم من حدث بهذا عن رسول الله إنما قال رسول الله كان أهل الجاهلية يقولون إن الطيرة

وقالت طائفة أخرى معنى الحديث إخباره عن الأسباب المثيرة للطيرة الكامنة في الغرائز يعنى أن المثير للطيرة في غرائز الناس هي هذه الثلاثة فأخبرنا بهذا لنأخذ الحذر منها فقال الشؤم في الدار والمرأة والفرس أي أن الحوادث التي تكثر مع هذه الأشياء والمصائب التي تتوالى عندها تدعو الناس إلى التشاؤم بها فقال الشؤم فيها أي أن الله قد يقدره فيها على قوم دون قوم فخاطبهم بذلك لما استقر عندهم منه من إبطال الطيرة وإنكار العدوى ولذلك لم يستفهموا في ذلك عن معنى ما أراده كما تقدم لهم في قوله لا يورد الممرض على المصح فقالوا عنده وما ذاك يا رسول الله فأخبرهم أنه خاف في ذلك الأذى الذي يدخله الممرض على المصح لا العدوى لأنه أمر بالتوادد وإدخال السرور بين المؤمنين وحسن التجاوز ونهى عن التقاطع والتباغض والأذى فمن اعتقد أن رسول الله نسب الطيرة والشؤم إلى شيء من الأشياء على سبيل إنه مؤثر بذلك دون الله فقد أعظم الفرية على الله وعلى رسوله وضل ضلالا بعيدا والنبي ابتداهم بنفي الطيرة والعدوى ثم قال الشؤم في ثلاث قطعا لتوهم

واقد بن عبد الله الحضري والحضرمي حضرت الحرب فكذب عليه وإنما قال ذلك أعداؤه من اليهود فتطيروا بذلك وتفاءلوا به فكانت الطيرة عليهم و وقدت الحرب عليهم

| الفصل الثامن والخمسون في الفأل والطيرة

فإن قلت : فلم نهى عن الخروج من البلد الذي فيه الوباء وسبب الوباء في الطب الهواء وأظهر طرق التداوي الفرار من المضر والهواء هو المضر وترك التوكل في أمثال هذا مباح وهذا لا يدل على المقصود ولكن الذي ينقدح فيه والعلم عند الله تعالى أن الهواء لا يضر من حيث إنه يلاقى ظاهر البدن بل من حيث دوام الاستنشاق له فانه اذا كان فيه عفونة ووصل إلى الرئة والقلب وباطن الأحشاء أثر فيها بطول الاستنشاق فلا يظهر الوباء على الظاهر إلا بعد طول التأثير في الباطن فالخروج من البلد لا يخلص غالبا من الأثر الذي استحكم من قبل ولكن يتوهم الخلاص فيصير هذا من جنس الموهومات كالرقي والطيرة وغيرهما ولو تجرد هذا المعنى لكان مناقضا للتوكل ولم يكن منهيا عنه ولكن صار منهيا عنه لانه انضاف اليه أمر آخر وهو أنه لو رخص للأصحاء في الخروج لما بقي في البلد إلا المرضى الذين أقعدهم الطاعون فانكسرت قلوبهم وفقدوا المتعهدين ولم يبق في البلد من يسقيهم الماء ويطعمهم الطعام وهم يعجزون عن مباشرتهما بأنفسهم فيكون ذلك سعيا في اهلاكهم تحقيقا وخلاصه

Exposure-based cognitive-behavioural therapy via the internet and as bibliotherapy for somatic symptom disorder and illness anxiety disorder: randomised controlled trial.: Background: In DSM-5 two new diagnoses, somatic symptom disorder (SSD) and illness anxiety disorder (IAD), have replaced DSM-IV hypochondriasis. There are no previous treatment studies for these disorders. Cognitive-behavioural therapy (CBT) delivered as therapist-guided or unguided internet treatment or as unguided bibliotherapy could be used to increase treatment accessibility. Aims: To investigate the effect of CBT delivered as guided internet treatment (ICBT), unguided internet treatment (U-

Interoceptive accuracy and bias in somatic symptom disorder, illness anxiety disorder, and functional syndromes: A systematic review and meta-analysis.: Somatic symptom disorder, illness anxiety disorder, and functional syndromes are characterized by burdensome preoccupation with somatic symptoms. Etiological models propose either increased interoceptive accuracy through hypervigilance to the body, or decreased and biased interoception through top-down predictions about sensory events. This systematic review and meta-analysis summarizes findings of 68 studies examining interoceptive accuracy and 8 studies examining response biases in clinical or

A randomized trial of treatments for high-utilizing somatizing patients.: Background: Somatization and hypochondriacal health anxiety are common sources of distress, impairment, and costly medical utilization in primary care practice. A range of interventions is needed to improve the care of these patients. Objective: To determine the effectiveness of two cognitive behavioral interventions for high-utilizing, somatizing patients, using the resources found in a routine care setting. Design: Patients were randomly assigned to a two-step cognitive behavioral treatment pr

Cognitive and perceptual variables in hypochondriasis and health anxiety: a systematic review.: This review examined (a) whether hypochondriacal/health-anxious individuals hold distinct assumptions about health and illness, (b) if triggering these assumptions leads to increased hypochondriacal concerns, and (c) whether these individuals perceive their bodily sensations differently from others (i.e., experience greater somatosensory amplification). There was clear evidence that health anxiety is related dysfunctional health-related beliefs. Few studies have examined how hypochondriacal conc

Medically unexplained symptoms, somatisation disorder and hypochondriasis: course and prognosis. A systematic review.: Objective: To study the course of medically unexplained symptoms (MUS), somatisation disorder, and hypochondriasis, and related prognostic factors. Knowledge of prognostic factors in patients presenting persistent MUS might improve our understanding of the naturalistic course and the identification of patients with a high risk of a chronic course. Methods: A comprehensive search of Medline, PsycInfo, CINAHL, and EMBASE was performed to select studies focusing on patients with MUS, somatisation d

Mechanistic studies in pathological health anxiety: A systematic review and emerging conceptual framework.: Background: Pathological health anxiety (PHA) (e.g., hypochondriasis and illness anxiety disorder) is common in medical settings and associated with increased healthcare costs. However, the psychological and neurobiological mechanisms contributing to the development and maintenance of PHA are incompletely understood. Methods: We performed a systematic review to characterize the mechanistic understanding of PHA. PubMed, PsycINFO, and Embase databases were searched to find articles published betwe

Pro-inflammatory cytokine associated with somatic and pain symptoms in depression.

Background: More than two-thirds of depressed patients complain of somatic and pain symptoms, which are frequently regarded as a psychological reaction. Although there is a growing body of evidence showing that depression is related to immune abnormalities, few studies have investigated the association between inflammatory cytokines and somatic/pain symptoms. Method: Patients with depressive disorder but without any medical disorders, and age/gender/body mass index (BMI)-matched healthy subjects were enrolled. All the subjects completed the self-rating scales of the Beck Depression Inventory-II and the Depression and Somatic Symptoms Scale, which was comprised of depressive, somatic, and pain subscales. Pro-inflammatory cytokines, including C-reactive protein (CRP), interleukin-2 receptor (sIL-2R), soluble interleukin 6 receptor (sIL-6R), soluble TNF-receptors (sTNF-R), soluble P-selecti…

matched on Somatoform Disorders (mesh), somatic symptom (text)

Somatic symptom disorder: an important change in DSM.

This paper describes the rationale for the new diagnosis of somatic symptom disorder (SSD) within DSM5. SSD represents a consolidation of a number of previously listed diagnoses. It deemphasizes the centrality of medically unexplained symptoms and defines the disorder on the basis of persistent somatic symptoms associated with disproportionate thoughts, feelings, and behaviors related to these symptoms. Data are presented concerning reliability, validity, and prevalence of SSD, as well as tasks for future research, education, and clinical practice.

matched on Somatoform Disorders (mesh), somatic symptom (text)

Total somatic symptom score as a predictor of health outcome in somatic symptom disorders.

Background: The diagnosis of somatisation disorder in DSM-IV was based on 'medically unexplained' symptoms, which is unsatisfactory. Aims: To determine the value of a total somatic symptom score as a predictor of health status and healthcare use after adjustment for anxiety, depression and general medical illness. Method: Data from nine population-based studies (total n = 28 377) were analysed. Results: In all cross-sectional analyses total somatic symptom score was associated with health status and healthcare use after adjustment for confounders. In two prospective studies total somatic symptom score predicted subsequent health status. This association appeared stronger than that for medically unexplained symptoms. Conclusions: Total somatic symptom score provides a predictor of health status and healthcare use over and above the effects of anxiety, depression and general medical illnes…

matched on Somatoform Disorders (mesh), somatic symptom (text)

Effects of childhood trauma on somatization in major depressive disorder: The role of alexithymia.

Background: Childhood trauma (CT) is often associated with later psychopathology, including depression, somatization, and alexithymia. The aim of the present study was to investigate the relationships of CT with somatization and alexithymia. Moreover, the effect of specific subtypes of trauma on alexithymia and somatization was also investigated. Methods: The present study was conducted on 100 outpatients with major depressive disorder (MDD) and 50 age and gender matched healthy controls (HC). Data were collected on each of the participants, including the Childhood Trauma Questionnaire (CTQ-28), the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS), a 20-item Toronto Alexithymia Scale (TAS), and a somatization subscale of the Symptom Check List-Revised Form (SCL-90 R). Patient groups were divided into two categories according to the TAS-20 cut-off score. R…

matched on Somatoform Disorders (mesh), somatic symptom (text)

Ethnic microaggressions and the depressive and somatic symptoms of Latino and Asian American adolescents.

Ethnic microaggressions are a form of everyday, interpersonal discrimination that are ambiguous and difficult to recognize as discrimination. This study examined the frequency and impact of microaggressions among Latino (n = 247) and Asian American (n = 113) adolescents (M (age) = 17.18, SD = .75; 57 % girls). Latino adolescents reported more frequent microaggressions that dismiss their realities of discrimination and microaggressions characterized by treatment as a second class citizen than Asian Americans, but similar levels of microaggressions that highlight differences or foreignness. There were no ethnic differences in the extent to which adolescents were bothered by microaggressions. Moreover, even supposedly innocuous forms of discrimination are associated with elevated levels of anxiety, anger, and stress, which may increase feelings of depression and sickness. Microaggressions s…

matched on Somatoform Disorders (mesh), somatic symptom (text)

Insecure attachment and frequent attendance in primary care: a longitudinal cohort study of medically unexplained symptom presentations in ten UK general practices.

Background: In primary care frequent attenders with medically unexplained symptoms (MUS) pose a clinical and health resource challenge. We sought to understand these presentations in terms of the doctor-patient relationship, specifically to test the hypothesis that such patients have insecure emotional attachment. Method: We undertook a cohort follow-up study of 410 patients with MUS. Baseline questionnaires assessed adult attachment style, psychological distress, beliefs about the symptom, non-specific somatic symptoms, and physical function. A telephone interview following consultation assessed health worry, general practitioner (GP) management and satisfaction with consultation. The main outcome was annual GP consultation rate. Results: Of consecutive attenders, 18% had an MUS. This group had a high mean consultation frequency of 5.24 [95% confidence interval (CI) 4.79-5.69] over the …

matched on Somatoform Disorders (mesh), somatic symptom (text)

Do medically unexplained somatic symptoms predict depression in older Chinese?

Objective: To identify the pattern of somatic presentation of depression among older Chinese by examining the association between medically unexplained somatic symptoms and depression. Subjects: The population comprised 1433 Chinese 65 years or older recruited from 11 older community centres distributed across the three main territory regions of Hong Kong. Method: Data were collected between January and December 2008, with a response rate of 72.3%. Data on socio-demographic background, medical profile and somatic symptoms were collected. The Mental Health Inventory (five-item) was used for depression screening. Medically unexplained somatic symptoms were defined as those not explained by any known medical pathology. Results: The prevalence of depression among older Chinese was 16.5%. They reported more frequently than did the non-depressed six medically unexplained somatic symptoms. Afte…

matched on Somatoform Disorders (mesh), somatic symptom (text)

Mental health among torture survivors: cultural background, refugee status and gender.

Background: The experience of torture places the survivors at a heightened risk for somatic and mental health problems. Aims: This study examined the role of culture, refugee status and gender in the mental and somatic health among help-seekers in a centre for torture survivors in Finland. Method: The 78 participants (29 women and 49 men) were interviewed and assessed with the Impact of Event Scale-Revised (IES-R) and the Hopkins Symptom Checklist-25 (HSCL-25) scales and their somatic complaints were registered. Groups with Middle Eastern, Central African, Southern Asian and South Eastern European cultural backgrounds were compared. Results: Group differences were found in post-traumatic stress disorder (PTSD) and depressive symptoms and somatic complaints. As hypothesized, Southern European torture survivors showed a higher level of PTSD than cultural groups from more traditional collec…

matched on Somatoform Disorders (mesh), somatic symptom (text)

One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders.

Background: In order to clarify the classification of physical complaints not attributable to verifiable, conventionally defined diseases, a new diagnosis of bodily distress syndrome was introduced. The aim of this study was to test if patients diagnosed with one of six different functional somatic syndromes or a DSM-IV somatoform disorder characterized by physical symptoms were captured by the new diagnosis. Method: A stratified sample of 978 consecutive patients from neurological (n=120) and medical (n=157) departments and from primary care (n=701) was examined applying post-hoc diagnoses based on the Schedules for Clinical Assessment in Neuropsychiatry diagnostic instrument. Diagnoses were assigned only to clinically relevant cases, i.e., patients with impairing illness. Results: Bodily distress syndrome included all patients with fibromyalgia (n=58); chronic fatigue syndrome (n=54) a…

matched on Somatoform Disorders (mesh), somatic symptom (text)

Symptoms and coping in Sri Lanka 20-21 months after the 2004 tsunami.

Background: The estimated prevalence of clinically significant psychiatric and somatic symptoms in adults >1 year after the 2004 Asian tsunami is unknown. Aims: To estimate the prevalence of psychiatric and somatic symptoms and impairment in Sri Lanka 20-21 months after the 2004 Asian tsunami, and to assess coping strategies used by tsunami-affected individuals that contribute to post-tsunami adjustment. Method: Homes from one severely affected area were randomly selected, and adult respondents were sampled utilising a modified Kish method. Instruments were administered in Sinhala to assess exposure, post-traumatic stress disorder (PTSD), depression, anxiety, somatic distress and impairment. Demographic variables and culturally-relevant coping activities were assessed. Results: The prevalence of clinically significant PTSD, depression and anxiety was 21%, 16% and 30% respectively. Respon…

matched on Somatoform Disorders (mesh), somatic symptom (text)

The mental health of clean-up workers 18 years after the Chernobyl accident.

Background: The psychological aftermath of the Chernobyl accident is regarded as the largest public health problem unleashed by the accident to date. Yet the mental health of the clean-up workers, who faced the greatest radiation exposure and threat to life, has not been systematically evaluated. This study describes the long-term psychological effects of Chernobyl in a sample of clean-up workers in Ukraine. Method: The cohorts were 295 male clean-up workers sent to Chernobyl between 1986 and 1990 interviewed 18 years after the accident (71% participation rate) and 397 geographically matched controls interviewed as part of the Ukraine World Mental Health (WMS) Survey 16 years after the accident. The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) was administered. We examined group differences in common psychiatric disorders, suicide ideation and sever…

matched on Somatoform Disorders (mesh), somatic symptom (text)

Prevalence, impact, and prognosis of multisomatoform disorder in primary care: a 5-year follow-up study.

Background: To determine the prevalence, impact, and prognosis of multisomatoform disorder (MSD) over a 5-year period in a primary care population. Although somatization is prevalent in primary care, patients rarely meet Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for somatization disorder. MSD, defined as > or = 3 bothersome, medically unexplained somatic symptoms, has been proposed as a more inclusive disorder. Methods: A total of 500 adults presenting to a primary care clinic with a physical symptom were screened with the Primary Care Evaluation of Mental Disorders. Symptom count was assessed with the Patient Health Questionnaire 15-item somatic symptom scale. Additional baseline measures included functional status and symptom characteristics. Follow-up surveys at 2 weeks, 3 months, and 5 years assessed functioning, symptom outcome, psychiatric…

matched on Somatoform Disorders (mesh), somatic symptom (text)

Symptoms and syndromes of bodily distress: an exploratory study of 978 internal medical, neurological, and primary care patients.

Objective: Physical complaints not attributable to verifiable, conventionally defined diseases, i.e., medically unexplained or functional somatic symptoms, are prevalent in all medical settings, but their classification is contested as numerous overlapping diagnoses and syndrome labels have been introduced. This study aims to determine whether functional somatic symptoms cluster into distinct syndromes and diagnostic entities. Methods: The 978 consecutively admitted patients from a neurological department (n = 120), a medical department (n = 157), and from primary care (n = 701) were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) diagnostic instrument. Results: Patients complained of a median of five functional somatic symptoms; women of six, men of four (p < .0001). No single symptoms stood out as distinctive for patients with multiple symptoms. Princi…

matched on Somatoform Disorders (mesh), somatic symptom (text)

Mapping the road from childhood trauma to adult somatization: the role of attachment.

Objective: This study tested whether insecure attachment mediates the link between childhood trauma and adult somatization. Methods: A community sample of 101 couples completed self-report measures, including the Relationship Scales Questionnaire, the Childhood Trauma Questionnaire, the Somatic Symptom Inventory, the Beck Depression Inventory, and the Conflict Tactics Scale. Results: Childhood trauma was associated with higher levels of somatization and insecure attachment. Insecure attachment style was also associated with higher levels of somatization. Controlling for age, income, and recent intimate partner violence, analyses showed that fearful attachment fully mediated the link between childhood trauma and somatization for women. For men, there was no such mediation, but both childhood trauma and insecure attachment styles made independent contributions to predicting levels of somat…

matched on Somatoform Disorders (mesh), somatic symptom (text)

Illness behavior and its predictors in young and middle-aged colorectal cancer patients: A latent profile analysis.

Purpose: To describe the characteristics of sick role adaptation and understand the differences in young and middle-aged colorectal cancer (CRC) patients. Methods: 225 colorectal cancer patients aged 18-59 admitting to a specialized oncology hospital in Guangzhou, China were involved from January to April 2022. Socio-demographic characteristics, disease-related characteristics, scores of Illness Behavior Questionnaire, Hospital Anxiety and Depression Scale, the Brief Illness Perception Questionnaire, Mishel Uncertainty in Illness Scale and Medical Coping Modes Questionnaire were applied to collect quantitative data. Latent profile analysis (LPA) of illness behavior, analysis of variance (ANOVA) and multiple logistic regression were performed. Results: Three latent classes of illness behavior were identified: low maladaptive illness behavior group, moderate maladaptive illness behavior gr…

matched on Illness Behavior (mesh)

From mechanism to ecosystem: building bridges between ecoimmunology, psychoneuroimmunology and disease ecology.

Historically, the fields of ecoimmunology, psychoneuroimmunology and disease ecology have taken complementary yet disparate theoretical and experimental approaches, despite sharing critical common themes. Researchers in these areas have largely worked independently of one another to understand mechanistic immunological responses, organismal level immune performance, behavioral changes, and host and parasite/disease population dynamics, with few bridges across disciplines. Although efforts to strengthen and expand these bridges have been called for (and occasionally heeded) over the last decade, more integrative studies are only now beginning to emerge, with critical gaps remaining. Here, we briefly discuss the origins of these key fields, and their current state of integration, while highlighting several critical directions that we suggest will strengthen their connections into the futur…

matched on Illness Behavior (mesh)

Brainstem ADCYAP1+ neurons control multiple aspects of sickness behaviour.

Infections induce a set of pleiotropic responses in animals, including anorexia, adipsia, lethargy and changes in temperature, collectively termed sickness behaviours1. Although these responses have been shown to be adaptive, the underlying neural mechanisms have not been elucidated2-4. Here we use of a set of unbiased methodologies to show that a specific subpopulation of neurons in the brainstem can control the diverse responses to a bacterial endotoxin (lipopolysaccharide (LPS)) that potently induces sickness behaviour. Whole-brain activity mapping revealed that subsets of neurons in the nucleus of the solitary tract (NTS) and the area postrema (AP) acutely express FOS after LPS treatment, and we found that subsequent reactivation of these specific neurons in FOS2A-iCreERT2 (also known as TRAP2) mice replicates the behavioural and thermal component of sickness. In addition, inhibition…

matched on Illness Behavior (mesh)

Illness perceptions and illness behaviours in back pain: A cross-sectional cluster analysis.

Background: Individuals' perceptions of back pain may shape what they do in response to manage their pain, for example, self-care, medication and seeking healthcare. Illness perceptions encompass a variety of beliefs such as how long pain is expected to last and whether treatments are perceived to control pain. Whether these beliefs meaningfully cluster and whether these clusters are associated with how people manage their back pain are currently unknown. Methods: 1,343 individuals with back pain from a general population sample completed the brief Illness Perceptions Questionnaire and measures about their pain and illness behaviours. Using a two-stage cluster analysis, we identified four distinct clusters of individuals. Logistic regression was used to investigate relationships between cluster membership and illness behaviours. Results: After adjustment for socio-demographic characteris…

matched on Illness Behavior (mesh)

Acute Inflammation Alters Brain Energy Metabolism in Mice and Humans: Role in Suppressed Spontaneous Activity, Impaired Cognition, and Delirium.

Systemic infection triggers a spectrum of metabolic and behavioral changes, collectively termed sickness behavior, which while adaptive, can affect mood and cognition. In vulnerable individuals, acute illness can also produce profound, maladaptive, cognitive dysfunction including delirium, but our understanding of delirium pathophysiology remains limited. Here, we used bacterial lipopolysaccharide (LPS) in female C57BL/6J mice and acute hip fracture in humans to address whether disrupted energy metabolism contributes to inflammation-induced behavioral and cognitive changes. LPS (250 µg/kg) induced hypoglycemia, which was mimicked by interleukin (IL)-1β (25 µg/kg) but not prevented in IL-1RI-/- mice, nor by IL-1 receptor antagonist (IL-1RA; 10 mg/kg). LPS suppression of locomotor activity correlated with blood glucose concentrations, was mitigated by exogenous glucose (2 g/kg), and was ex…

matched on Illness Behavior (mesh)

Two Distinct Immune Pathways Linking Social Relationships With Health: Inflammatory and Antiviral Processes.

Objective: Social relationships can both influence and be influenced by immune processes. Past work implicates two distinct pathways along which this interaction may occur: inflammatory processes and antiviral processes. This article reviews how social behavior is modulated by these two immune processes and how such processes may in turn regulate social behavior. Methods: This narrative review outlines existing work on social behavior and both inflammatory and antiviral processes. We propose an evolutionary framework that aims to integrate these findings. Specifically, social isolation has evolutionarily increased the likelihood of wounding and therefore increased the need for inflammation, which works to promote healing. Conversely, broader social networks provide protection from physical threats but also lead to increased pathogen exposure, necessitating a more robust antiviral respons…

matched on Illness Behavior (mesh)

Probiotic consumption during puberty mitigates LPS-induced immune responses and protects against stress-induced depression- and anxiety-like behaviors in adulthood in a sex-specific manner.

Puberty/adolescence is a significant period of development and a time with a high emergence of psychiatric disorders. During this period, there is increased neuroplasticity and heightened vulnerability to stress and inflammation. The gut microbiome regulates stress and inflammatory responses and can alter brain chemistry and behaviour. However, the role of the gut microbiota during pubertal development remains largely uninvestigated. The current study examined gut manipulation with probiotics during puberty in CD1 mice on lipopolysaccharide (LPS)-induced immune responses and enduring effects on anxiety- and depression-like behaviours and stress-reactivity in adulthood. Probiotics reduced LPS-induced sickness behaviour at 12 h in females and at 48 h following LPS treatment in males. Probiotics also reduced LPS-induced changes in body weight at 48 h post-treatment in females. Probiotic tre…

matched on Illness Behavior (mesh)

Illness identity in young adults with refractory epilepsy.

Introduction: Refractory epilepsy is an intrusive condition with important implications for daily functioning in emerging and young adulthood. The present study examined the degree to which refractory epilepsy is integrated in one's identity, and examined how such a sense of illness identity was related to health-related quality of life (HRQOL). Methods: A total of 121 18- to 40-year-old patients with refractory epilepsy (56.2% women) completed self-report questionnaires assessing the four illness identity states of acceptance, enrichment, engulfment, and rejection (Illness Identity Questionnaire (IIQ)); HRQOL (Quality of Life in Epilepsy Inventory - 31); and seizure frequency and severity (Liverpool Seizure Severity Scale (LSSS)). Illness identity scores were compared with a sample of 191 patients with a nonneurological chronic disease (congenital heart disease). Hierarchical regression…

matched on Illness Behavior (mesh)

Interferon-alpha treatment induces depression-like behaviour accompanied by elevated hippocampal quinolinic acid levels in rats.

Immunotherapy with the cytokine interferon-alpha (IFN-α) can induce symptoms of depression, and it is likely that the tryptophan-kynurenine pathway may be involved in this regard. In this study we investigated the effects of IFN-α on depression-like behaviour and central metabolites of the tryptophan-kynurenine pathway in rats. Secondly, we explored the modulating effects of an antidepressant (imipramine) and anti-inflammatory drug (celecoxib) on IFN-α-induced behavioural and pathophysiological changes in the brain. The following treatment groups were used: Control (saline), IFN-α (6×10(4)IU/kg s.c.), IFN-α+imipramine or IFN-α+celecoxib. Drugs were administered daily for 1 week. IFN-α treatment induced depression-like behaviour by increasing immobility in the forced swim test (FST), and decreased tryptophan levels in the brain. There was a trend for an increased kynurenine/tryptophan rat…

matched on Illness Behavior (mesh)

Why Do We Feel Sick When Infected--Can Altruism Play a Role?

When we contract an infection, we typically feel sick and behave accordingly. Symptoms of sickness behavior (SB) include anorexia, hypersomnia, depression, and reduced social interactions. SB affects species spanning from arthropods to vertebrates, is triggered nonspecifically by viruses, bacteria, and parasites, and is orchestrated by a complex network of cytokines and neuroendocrine pathways; clearly, it has been naturally selected. Nonetheless, SB seems evolutionarily costly: it promotes starvation and predation and reduces reproductive opportunities. How could SB persist? Former explanations focused on individual fitness, invoking improved resistance to pathogens. Could prevention of disease transmission, propagating in populations through kin selection, also contribute to SB?

matched on Illness Behavior (mesh)

Self-reported symptoms and healthcare seeking in the general population--exploring "The Symptom Iceberg".

Background: Research has illustrated that the decision-making process regarding healthcare seeking for symptoms is complex and associated with a variety of factors, including gender differences. Enhanced understanding of the frequency of symptoms and the healthcare seeking behaviour in the general population may increase our knowledge of this complex field. The primary objective of this study was to estimate the prevalence of self-reported symptoms and the proportion of individuals reporting GP contact, in a large Danish nationwide cohort. A secondary objective was to explore gender differences in GP contacts in response to experiencing one of the 44 predefined symptoms. Methods: A Danish nationwide cohort study including a random sample of 100,000 individuals, representative of the adult Danish population aged 20 years or above. A web-based questionnaire survey formed the basis of this …

matched on Illness Behavior (mesh)