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

Fearful Attachment Linked to Childhood Abuse, Alexithymia, and Depression in Motor Functional Neurological Disorders.

Insecure attachment is a predisposing risk factor for the development of functional neurological disorder (FND). There is limited research investigating connections between attachment styles, other predisposing vulnerabilities, and symptom severity in patients with motor FND. By using a within-group design with prospective data collection, the authors performed univariate tests followed by multivariate linear regressions to investigate neuropsychiatric factors associated with four attachment styles (secure, fearful, preoccupied, and dismissing) among 56 patients with motor FND (mean age=40.2 years [SD=13.0]; women, N=41; men, N=15). In univariate analyses, fearful attachment style was associated with self-reported adverse life event burden, alexithymia, dissociation, depression, anxiety, impaired stress coping skills, functional neurologic symptom severity, and marital status. In a multi…

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Euthanasia and Assisted Suicide of Patients With Psychiatric Disorders in the Netherlands 2011 to 2014.

Importance: Euthanasia or assisted suicide (EAS) of psychiatric patients is increasing in some jurisdictions such as Belgium and the Netherlands. However, little is known about the practice, and it remains controversial. Objectives: To describe the characteristics of patients receiving EAS for psychiatric conditions and how the practice is regulated in the Netherlands. Design, setting, and participants: This investigation reviewed psychiatric EAS case summaries made available online by the Dutch regional euthanasia review committees as of June 1, 2015. Two senior psychiatrists used directed content analysis to review and code the reports. In total, 66 cases from 2011 to 2014 were reviewed. Main outcomes and measures: Clinical and social characteristics of patients, physician review process of the patients' requests, and the euthanasia review committees' assessments of the physicians' act…

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On the interaction of self-regulation, interoception and pain perception.

Background: Interoceptive processes were found to be associated with better self-regulation capacities in healthy participants. Further empirical research suggests that interoceptive sensitivity is also important for the perception of pain both in healthy participants and in somatoform patients. Nevertheless, little is known about the interaction of interoceptive processes and self-regulation for pain. We therefore conducted a study examining the interaction of interoception and self-regulation in somatoform patients. Methods: We investigated interoceptive sensitivity and self-regulatory capacities in 30 somatoform patients and 30 healthy controls when experimentally assessing pain threshold and pain tolerance. Results: Interoceptive sensitivity was associated with better self-regulation capacities. Somatoform patients exhibited a significantly reduced interoceptive sensitivity and reduc…

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Adult health outcomes of childhood bullying victimization: evidence from a five-decade longitudinal British birth cohort.

Objective: The authors examined midlife outcomes of childhood bullying victimization. Method: Data were from the British National Child Development Study, a 50-year prospective cohort of births in 1 week in 1958. The authors conducted ordinal logistic and linear regressions on data from 7,771 participants whose parents reported bullying exposure at ages 7 and 11 years, and who participated in follow-up assessments between ages 23 and 50 years. Outcomes included suicidality and diagnoses of depression, anxiety disorders, and alcohol dependence at age 45; psychological distress and general health at ages 23 and 50; and cognitive functioning, socioeconomic status, social relationships, and well-being at age 50. Results: Participants who were bullied in childhood had increased levels of psychological distress at ages 23 and 50. Victims of frequent bullying had higher rates of depression (odd…

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Seminal, ultrasound and psychobiological parameters correlate with metabolic syndrome in male members of infertile couples.

Metabolic syndrome (MetS) is a diagnostic category which identifies subjects at high risk for diabetes and cardiovascular diseases, erectile dysfunction (ED) and male hypogonadism. However, MetS impact on male infertility has been poorly studied. We systematically evaluated possible associations between MetS and clinical characteristics in men with couple infertility. Out of 367 consecutive subjects, 351 men without genetic abnormalities were studied. MetS was defined according to the International Diabetes Federation&American Heart Association/National Heart,Lung, and Blood Institute classification. All men underwent physical, hormonal, seminal and scrotal ultrasound evaluation. Erectile and ejaculatory functions were assessed by International Index of Erectile Function-15 erectile function domain (IIEF-15-EFD) and Premature Ejaculation Diagnostic Tool (PEDT), respectively, while psycho…

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Stigma, mental health, and resilience in an online sample of the US transgender population.

Objectives: We assessed the association between minority stress, mental health, and potential ameliorating factors in a large, community-based, geographically diverse sample of the US transgender population. Methods: In 2003, we recruited through the Internet a sample of 1093 male-to-female and female-to-male transgender persons, stratified by gender. Participants completed an online survey that included standardized measures of mental health. Guided by the minority stress model, we evaluated associations between stigma and mental health and tested whether indicators of resilience (family support, peer support, identity pride) moderated these associations. Results: Respondents had a high prevalence of clinical depression (44.1%), anxiety (33.2%), and somatization (27.5%). Social stigma was positively associated with psychological distress. Peer support (from other transgender people) mod…

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Symbolic diseases and "mindbody" co-emergence. A challenge for psychoneuroimmunology.

Physical diseases that appear to be symbolic somatic representations of patients' personal meanings or individual 'stories' continue to be reported in the medical literature. The identification of a symbolic disease requires a clinical focus upon a patient's highly individual and nuanced meanings largely rendered invisible by the usual methodologies of clinical and research medicine, which has no coherent model for understanding symbolic disease. Therefore, a model is proposed of co-emergence of physicality and subjectivity, body and mind, disease and meaning, disease and symbol, which does provide a coherent basis for understanding symbolic disease. The 'mindbody' co-emergence model avoids mind and body dualism, assumes unbroken continuity between internal body processes and external interpersonal meanings and influences, and asserts that disease-related 'internal' bodily changes and co…

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Is alexithymia associated with specific mental disorders?

Background: Alexithymia is characterized by restrictions in the perception, differentiation and regulation of affects. It is considered to be an important vulnerability factor for the development of mental disorders. Little is known, however, of whether alexithymia is associated with specific mental disorders. Sampling and methods: Data from 1,461 patients of an outpatient clinic for psychosomatic medicine with various mental disorders (depressive disorders, anxiety disorders, adjustment disorders, somatoform disorders, eating disorders, and psychological and behavioral factors of physical illness) were collected between January 2007 and October 2009. The 20-item Toronto Alexithymia Scale (TAS-20) was administered to study alexithymia. The diagnoses were made following ICD-10 guidelines. Results: In our sample, the total prevalence of alexithymia (TAS-20 ≥ 61) was 21.36%. The percentage …

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Psychological distress and unmet supportive care needs in cancer patients and carers who contact cancer helplines.

Cancer information services are a highly accessible source of support for people affected by cancer. To date the nature and extent of distress experienced by such callers and their unmet support needs have not been well described. A cross-sectional survey of 354 cancer patients and 336 carers who reported elevated distress on contact with a cancer information service assessed socio-demographic variables; anxiety, depression and somatization; unmet supportive care needs; cancer-specific distress; presenting problems; post-traumatic growth. Adjustment to cancer was most commonly reported; followed by anxiety. In all, 53.4% of patients and 45.2% of carers reached caseness in anxiety, depression or somatization. Carers had higher distress ratings and intrusive thinking compared to patients; whereas patients had higher somatization. For patients, most unmet supportive care needs were psycholo…

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Anxiety, depression, and pain in burning mouth syndrome: first chicken or egg?

Background: Burning mouth syndrome (BMS) is an idiopathic and chronic pain condition for which patients may experience high levels of pain, anxiety, and depression. So far, it has not yet been well investigated whether specific psychiatric features (anxious traits, personality disorder, or somatization) may play a role in the BMS pathogenesis or whether some BMS symptoms, or BMS itself, may cause secondary psychiatric symptoms. Objective: The aim of this study was to evaluate the relationship between pain, depression, and anxiety in BMS and healthy patients in order to hypothesize a possible underlying pathogenetic model. Methods: Fifty-three patients with BMS and 51 healthy volunteers matched for sex and age were enrolled. All patients underwent a physical examination, laboratory screening tests, and psychiatric assessment with the following instruments: Visual Analog Scale, the Hamilto…

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Presentation of the Multidisciplinary Guideline Medically Unexplained Physical Symptoms (MUPS) and Somatoform Disorder in the Netherlands: disease management according to risk profiles.

Objective: January 2011, the Dutch Multidisciplinary Guideline for Medically Unexplained Symptoms (MUPS) and Somatoform Disorder (SD) was published. The aim was to set a standard for multidisciplinary prevention, diagnosis and treatment of MUPS and SD. Methods: First, the Multidisciplinary Guideline group defined a conceptual approach for the guideline. After this, a systematic literature review, followed by consensus meetings in the Multidisciplinary working group, aimed to answer the following questions: 1) What evidence exists for preventive interventions, including the patient-doctor communication in MUPS and SD? 2) How can the diagnosis of MUPS be established? 3) What effective treatments of MUPS are available? 4) Which types of treatment are most effective for which patients? Results: As conceptual approach for the guideline, based on existing literature, in this guideline MUPS are…

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Loneliness impairs daytime functioning but not sleep duration.

Objective: To assess the prospective association between daily feelings of loneliness and subsequent feelings of daytime dysfunction indicative of poor sleep quality. Design: Three consecutive end-of-day diaries were completed by a population-based sample of 215 adults (mean age = 57.5 years, SD = 4.4). Diary questions probed sleep duration, daytime dysfunction (i.e., fatigue, low energy, sleepiness), loneliness, physical symptoms, and depressed affect experienced that day. Chronic health condition data and body mass index were also obtained. Autoregressive cross-lagged panel models were used to examine the magnitude of reciprocal prospective associations between loneliness and daytime dysfunction. Main outcome measures: Unstandardized path coefficients adjusted for race/ethnicity, sleep duration, marital status, household income, chronic health conditions, and health symptom severity. R…

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Which factors predict the persistence of DSM-IV depression, anxiety, and somatoform disorders in the medically ill three months post hospital discharge?

Objective: This study sought to assess the persistence of DSM-IV depression, anxiety, and somatoform disorders in a sample of 206 medical patients 3 months after hospital discharge and to examine which baseline factors predicted the persistence of disorder. Methods: Patients were interviewed using the Monash Interview for Liaison Psychiatry (a structured psychiatric interview for the medically ill) during admission and again at 3 months post discharge. Scales completed during admission elicited sociodemographic data, psychiatric history, mental and physical functioning, illness behavior, coping modes, and number of close relationships. Best-subset logistic regression was employed to find the best combination of these potential predictors of the persistence of psychiatric disorder. Results: Persistence of anxiety disorders [n=43; 50.6%; 95% CI=39.5-61.6], depression (n=55; 44.4%; 95% CI=3…

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Motivation for psychotherapy in patients with functional gastrointestinal disorders.

Background: The motivation of patients with functional gastrointestinal disorders to accept psychotherapy (PT) as a treatment option is not known. Objective: The authors investigated motivation for patients' refusal to participate and dropout from PT/medical management programs. Method: Consecutive patients with symptoms suggestive of functional bowel disorders, seen at the outpatient clinic of a tertiary gastrointestinal (GI) center were evaluated for their motivation to undergo PT. Data from 85 patients were evaluated in two phases: In Phase 1, patients were asked about willingness to participate in PT if it were offered; in Phase 2, patients were offered PT. In both samples, PT motivation was also measured by standardized psychometric scales. Results: Age, gender, social status, and clinical symptom severity did not predict willingness to participate in or accept PT. Motivation was hi…

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Childhood trauma and dissociation in schizophrenia.

Background: This study is concerned with relationships between childhood trauma history, dissociative experiences, and the clinical phenomenology of chronic schizophrenia. Sampling and methods: Seventy patients with a schizophrenic disorder were evaluated using the Structured Clinical Interview for DSM-IV, Dissociative Experiences Scale, Dissociative Disorders Interview Schedule, Positive and Negative Symptoms Scales, and Childhood Trauma Questionnaire. Results: Childhood trauma scores were correlated with dissociation scale scores and dissociative symptom clusters, but not with core symptoms of the schizophrenic disorder. Cluster analysis identified a subgroup of patients with high dissociation and childhood trauma history. The dissociative subgroup was characterized by higher numbers of general psychiatric comorbidities, secondary features of dissociative identity disorder, Schneideria…

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Screening for anxiety disorders in children.

Anxiety disorders are highly prevalent and have negative consequences on individual and societal level. This study examined the usefulness of screening for anxiety disorders in primary school children. More specifically, the value of the screening method to discriminate between and to predict anxiety disorders was studied. Children and their parents were selected if the children had self-reported scores on the screening questionnaire Screen for Child Anxiety Related Emotional Disorders-71 (SCARED-71) within the top-15% (High-anxious) or from two points below to two points above the median (Median-anxious). Of the selected children, 183 high-anxious children and their parents, and 80 median-anxious children and their parents took part in a diagnostic interview, the Anxiety Disorder Interview Schedule (ADIS). Of the high-anxious children, 60% had an anxiety disorder versus 23% of the media…

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Insecure attachment style is associated with chronic widespread pain.

Individuals with "insecure" adult attachment styles have been shown to experience more pain than people with secure attachment, though results of previous studies have been inconsistent. We performed a cross-sectional study on a large population-based sample to investigate whether, compared to pain free individuals, subjects with chronic widespread pain were more likely to report insecure adult attachment style. Subjects in a population-based cross-sectional study completed a self-rated assessment of adult attachment style. Attachment style was categorised as secure (i.e., normal attachment style); or preoccupied, dismissing or fearful (insecure attachment styles). Subjects completed a pain questionnaire from which three groups were identified: pain free; chronic widespread pain; and other pain. Subjects rated their pain intensity and pain-related disability on an 11 point Likert scale. …

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Shift work disorder among oil rig workers in the North Sea.

Study objectives: Shift work disorder (SWD) is a circadian rhythm sleep disorder caused by work hours during the usual sleep period. The main symptoms are excessive sleepiness and insomnia temporally associated with the working schedule. The aim of the present study was to examine SWD among shift workers in the North Sea. Design and participants: A total of 103 shift workers (2 weeks on 7 nights/7days, 12-h shifts, 4 weeks off), mean age 39.8 years, working at an oil rig in the North Sea responded to a questionnaire about SWD. They also completed the Pittsburgh Sleep Quality Index, Bergen Insomnia Scale, Epworth Sleepiness Scale, Composite Morningness Questionnaire, Subjective Health Complaint Inventory, Demand/Control, and Instrumental Mastery Oriented Coping (based on the Utrecht Coping list). Most of these instruments were administered during the first day of the 2-week working period…

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[Psychopathologies encountered on the island of Mayotte between 1998 and 2004].

Before 2001, psychiatric care on the island of Mayotte was ensured by missionaries from the Reunion Island. A mental health system has since been gradually installed, although the culture in Mayotte, mixing practicing Muslim women and traditional animists, still leaves a broad place for traditional healers. This paper presents a retrospective study of 1212 psychiatric case reports, aimed at indexing the various psychopathologies according to the CIM 10, on the island of Mayotte between 1998 and 2004. The files, before and after the opening of the mental health centre, were compared with those of the psychiatric diagnoses of the Comorians. The results show an evolution in the chronic pathologies treated in the Comorians: delirious disorders, and the organic, major, mental disorders in the first psychiatric files have given way to depressive episodes and somatoform disorders. Nevertheless,…

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Personal and workgroup incivility: impact on work and health outcomes.

This article develops a theoretical model of the impact of workplace incivility on employees' occupational and psychological well-being. In Study 1, the authors tested the model on 1,158 employees, finding that satisfaction with work and supervisors, as well as mental health, partially mediated effects of personal incivility on turnover intentions and physical health; this process did not vary by gender. Study 2 cross-validated and extended these results on an independent sample of 271 employees, showing negative effects of workgroup incivility that emerged over and above the impact of personal incivility. In both studies, all results held while controlling for general job stress. Implications for organizational science and practice are discussed.

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Relations among multiple peer influences, body dissatisfaction, eating disturbance, and self-esteem: a comparison of average weight, at risk of overweight, and overweight adolescent girls.

Objective: The goal of this study was to evaluate peer-related influences on appearance, body dissatisfaction, eating disturbance, and self-esteem in average weight, at risk of overweight, and overweight adolescent girls. Methods: Three hundred twenty-five adolescent girls from high schools in Florida were assessed. Ninety met criteria for being at risk of overweight or overweight. Logistic and multiple regression analyses were used to evaluate group differences on all variables and to assess the amount of variance accounted for by peer-influence variables in the prediction of body dissatisfaction, eating disturbance, and self-esteem. Results: Overweight and at risk of overweight girls scored higher than average weight girls on body dissatisfaction, dieting, and a peer measure that assessed negative comments and attributions about appearance. They also scored lower than average weight gi…

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Trajectories of internalizing problems across childhood: heterogeneity, external validity, and gender differences.

Developmental psychopathology theory speaks to the existence of early-manifesting internalizing problems with a heterogeneous longitudinal course. However, the course of internalizing problems has been investigated largely from late childhood onward, with methods that assume children's problem trajectories vary more so in rate than in qualitative functional form. This can obscure heterogeneity in symptom process and course, obscure onset of early gender differences in internalizing problems, and obscure the relevance of early sociocontextual risks for long-term internalizing outcomes. The present study addressed these issues by using person-oriented (latent growth mixture) methods to model heterogeneity in maternal-reported internalizing symptoms from age 2 to 11 years (N = 1,364). Three latent trajectory classes were supported for each gender: two-thirds of children followed a low-stabl…

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The relation between anger coping strategies, anger mood and somatic complaints in children and adolescents.

Attempts to explain the experience of somatic complaints among children and adolescents suggest that they may in part result from the influence of particular strategies for coping with anger on the longevity of negative emotions. To explore these relationships British (n = 393) and Dutch (n = 299) children completed a modified version of the Behavioral Anger Response Questionnaire (BARQ), and two additional questionnaires assessing anger mood and somatic complaints. A hierarchical regression analysis showed that for both the UK and Dutch samples two coping styles, Social support-seeking and Rumination, made a significant contribution to somatic complaints, over and above the variance explained by anger mood. A tendency to repeatedly think or talk about an angering event as a way of coping seems to underlie the observed negative health effects. In addition, tentative support is given for …

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Subgrouping outpatients of an environmental medicine unit using SCL-90-R and cluster analysis.

Between 1999 and 2003 all consecutive outpatients of the environmental medicine unit of the Charité hospital in Berlin were invited to participate in a study on environmentally related disorders. One hundred and sixty-nine of the patients completed a psychosocial questionnaire which comprised SCL-90-R and 14 other tests. When compared with clinical controls, SCL-90-R mean scores of the environmental patients (EP) were found to lie in between those of inpatients of a psychosomatic clinic and melanoma aftercare patients; but they were, with exception of the somatisation dimension, much closer to the latter. Application of the TwoStep Cluster component of SPSS resulted in three subgroups with high, moderate and low scores which were significantly different (p<0.001) although separation was incomplete (87% correct identification; cross-validated discriminant analysis). With all subgroups, sc…

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Alexithymia, coping, and illness behavior correlates of pain experience in cancer patients.

This paper aimed to investigate the role played by key psychological factors in the experience of pain in cancer. One hundred and eight consecutive cancer patients were administered validated scales for pain, alexithymia, coping with cancer, and illness behavior. Two groups of patients with (n=45, 42%) and without (n=63, 58%) current pain were compared. Pain was associated to tumor sites and status, poor adjustment to cancer, and higher disease conviction and perception, but not to global alexithymia. However, the component of difficulty identifying feelings (DIF) of the alexithymia construct was significantly higher in pain patients compared to pain-free patients (t=2.88, p<0.01), constituted one of the independent predictors of pain (r=0.37; beta=0.27, p<0.01), and correlated with quality descriptors of pain (r=0.33, p<0.05). The present findings showed for the first time that although…

matched on Somatoform Disorders (mesh)