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

Detecting DSM-5 somatic symptom disorder: criterion validity of the Patient Health Questionnaire-15 (PHQ-15) and the Somatic Symptom Scale-8 (SSS-8) in combination with the Somatic Symptom Disorder - B Criteria Scale (SSD-12).

Background: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced somatic symptom and related disorders (SSD) to improve the diagnosis of somatoform disorders. It is unclear whether existing questionnaires are useful to identify patients with SSD. Our study investigates the diagnostic accuracy of the Patient Health Questionnaire-15 (PHQ-15) and the Somatic Symptom Scale-8 (SSS-8) in combination with the Somatic Symptom Disorder - B Criteria Scale (SSD-12). Methods: For this cross-sectional study, participants were recruited from a psychosomatic outpatient clinic. PHQ-15, SSS-8, and SSD-12 were administered and compared with SSD criteria from a diagnostic interview. Sensitivity and specificity were calculated for optimal individual and combined cutpoints. Receiver operator curves were created and area under the curve (AUC) analyses assessed. Res…

matched on Medically Unexplained Symptoms (mesh), Somatoform Disorders (mesh), somatic symptom (text)

Clinical and economic outcomes of remotely delivered cognitive behaviour therapy versus treatment as usual for repeat unscheduled care users with severe health anxiety: a multicentre randomised controlled trial.

Background: It is challenging to engage repeat users of unscheduled healthcare with severe health anxiety in psychological help and high service costs are incurred. We investigated whether clinical and economic outcomes were improved by offering remote cognitive behaviour therapy (RCBT) using videoconferencing or telephone compared to treatment as usual (TAU). Methods: A single-blind, parallel group, multicentre randomised controlled trial was undertaken in primary and general hospital care. Participants were aged ≥18 years with ≥2 unscheduled healthcare contacts within 12 months and scored >18 on the Health Anxiety Inventory. Randomisation to RCBT or TAU was stratified by site, with allocation conveyed to a trial administrator, research assessors masked to outcome. Data were collected at baseline, 3, 6, 9 and 12 months. The primary outcome was change in HAI score from baseline to six mo…

matched on Hypochondriasis (keyword), health anxiety (text)

Therapist differences in a randomised trial of the outcome of cognitive behaviour therapy for health anxiety in medical patients.

Background: Health anxiety is common in medical settings and can be treated successfully by cognitive behaviour therapy. However it is not clear who might be best placed to deliver this therapy. Objectives: In a planned secondary analysis of data from a randomised trial of adapted cognitive behaviour therapy for health anxiety we compared outcomes of therapy delivered by nurses and other professional groups. Design: A randomised controlled trial with two treatment arms, 5-10 sessions of cognitive behaviour therapy adapted health anxiety or standard care. Setting: Cardiology, endocrine, gastroenterology, neurological and respiratory clinics in six general hospitals in the UK covering urban, suburban and rural areas. Participants: Medical patients attending the clinics who had pathological health anxiety and also scored for a diagnosis of hypochondriasis. Methods: Patients were randomised …

matched on Hypochondriasis (keyword), health anxiety (text)

Behavioural modification interventions for medically unexplained symptoms in primary care: systematic reviews and economic evaluation.

Background: The term 'medically unexplained symptoms' is used to cover a wide range of persistent bodily complaints for which adequate examination and appropriate investigations do not reveal sufficiently explanatory structural or other specified pathologies. A wide range of interventions may be delivered to patients presenting with medically unexplained symptoms in primary care. Many of these therapies aim to change the behaviours of the individual who may have worsening symptoms. Objectives: An evidence synthesis to determine the clinical effectiveness and cost-effectiveness of behavioural modification interventions for medically unexplained symptoms delivered in primary care settings was undertaken. Barriers to and facilitators of the effectiveness and acceptability of these interventions from the perspective of patients and service providers were evaluated through qualitative review …

matched on Medically Unexplained Symptoms (mesh)

A systematic review of resilience in the physically ill.

Background: Resilience is the capacity of individuals to maintain, or regain, their mental health in the face of significant adversity, including physical illness. Objective: We conducted a systematic review of resilience and related concepts in the physically ill to determine factors associated with predicting or promoting resilience. Methods: An electronic search of PsychInfo, Medline, and CINAHL databases between 1950 and May 2009 was performed using the terms resilience, and various types of physical illnesses. Inclusion criteria were broad and exclusion criteria were not published in English or not focused on resilience in physical illness. Results: A total of 475 articles were retrieved and 52 articles met inclusion/exclusion criteria. Psychological factors associated with resilience were self-efficacy, self-esteem, internal locus of control, optimism, mastery, hardiness, hope, sel…

matched on Illness Behavior (mesh)

A review of psychological correlates of adjustment in patients with multiple sclerosis.

Multiple Sclerosis (MS) is a chronic neurological disease which poses significant psychological adjustment challenges. The purpose of this systematic review was to identify factors that are related to adjustment in people with MS and may be modifiable through psychological intervention. It aimed to gain an overview of the strength of evidence for relationships between psychological factors and adjustment and identify limitations to existing studies and directions for future research. Seventy two studies met inclusion criteria and were included in the review and a narrative synthesis was conducted. A wide range of psychological factors have been studied in relation to adjustment outcomes. The strongest and most consistent finding was that perceived stress and certain emotion-focussed coping strategies are related to worse adjustment in MS. Uncertainty was fairly robustly associated with w…

matched on Illness Behavior (mesh)

The CSS-12: Development and Validation of a Short-Form Version of the Cyberchondria Severity Scale.

Cyberchondria is defined as an increase in anxiety about one's health status as a result of excessive online searches. McElroy and Shevlin (2014) developed the first multidimensional, self-report measure of this construct-the Cyberchondria Severity Scale (CSS). The CSS consists of 33 items which can be summed to form a total score, and/or 5 subscale scores. The aim of the present study was to develop a short-form version of the CSS, removing the "Mistrust" subscale. Participants were undergraduate students from two UK universities (N = 661, 73% female, Mage = 22.19 years, SD = 5.88). Students completed the CSS, Short Health Anxiety Inventory (SHAI) and Generalized Anxiety Disorder Assessment (GAD-7). Twelve items were chosen for retention in the short form based on an exploratory factor analysis. These items corresponded to the four factors previously identified in the 33-item scale (min…

matched on Hypochondriasis (mesh), health anxiety (text)

Strengthening competence of therapists-in-training in the treatment of health anxiety (hypochondriasis): Validation of the Assessment of Core CBT Skills (ACCS).

Although the observation and assessment of psychotherapeutic competences are central to training, supervision, patient care, quality control, and life-long practice, structured instruments are used only occasionally. In the current study, an observation-based tool for the Assessment of Core CBT Skills (ACCS) was translated into German and adapted, and its psychometric properties were pilot evaluated. Competence of therapists-in-training was assessed in a random sample of n = 30 videos on cognitive behavioural therapy including patients diagnosed with hypochondriasis. Two of three raters independently assessed the competences demonstrated in the entire, active treatment sessions (n = 60). In our sample, internal consistency was excellent, and interrater reliability was good. Convergent validity (Cognitive Therapy Scale) and discriminant validity (Helping Alliance Questionnaire) were withi…

matched on Hypochondriasis (mesh), health anxiety (text)

The effects of safety behaviors on health anxiety: an experimental investigation.

The present study examined the extent to which safety behaviors exacerbate symptoms of hypochondriasis (severe health anxiety). Participants were randomized into a safety behavior (n=30) or control condition (n=30). After a baseline period, participants in the safety behavior condition spent one week actively engaging in a clinically representative array of health-related safety behaviors on a daily basis, followed by a second week-long baseline period. Participants in the control condition monitored their normal use of safety behaviors. Compared to control participants, those in the safety behavior condition reported significantly greater increases in health anxiety, hypochondriacal beliefs, contamination fear, and avoidant responses to health-related behavioral tasks after the safety behavior manipulation. In contrast, general anxiety symptoms did not significantly differ between the t…

matched on Hypochondriasis (mesh), health anxiety (text)

Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): an interpretative phenomenological analysis of patients' experiences.

OBJECTIVE. Severe health anxiety (hypochondriasis) is a common and disabling condition for which existing psychological treatments have limited effects (Thomson & Page, 2007). Hence, it is a priority to examine both the efficacy and acceptability of new psychological treatments for health anxiety. The aim of this study was to explore the experiences of participants with severe health anxiety who received Mindfulness-based Cognitive Therapy (MBCT) as part of a randomized controlled trial. DESIGN. Semi-structured interviews were carried out 3 months after participants completed MBCT in order to explore their experiences of the course and subsequent self-managed practice. METHODS. Interpretative Phenomenological Analysis (Smith, 1996) was used to analyze interview transcripts from nine participants who had received MBCT. RESULTS. Two main themes emerged from the analysis: (1) My awareness o…

matched on Hypochondriasis (mesh), health anxiety (text)

Evaluating an e-mental health program ("deprexis") as adjunctive treatment tool in psychotherapy for depression: Results of a pragmatic randomized controlled trial.

Background: Depressive disorders place a significant disease burden on individuals as well as on societies. Several web-based interventions for depression have shown to be effective in reducing depressive symptoms. However, it is not known whether web-based interventions, when used as adjunctive treatment tools to regular psychotherapy, have an additional effect compared to regular psychotherapy for depression. Methods: Adults (N = 98) with a unipolar affective disorder were recruited in routine outpatient psychotherapy practices in Germany from therapists over the course of their initial sessions and randomized within therapists to one of two active treatment conditions: regular psychotherapy or psychotherapy plus a web-based depression program ("deprexis"). Primary outcome was depressive symptoms measured with the Beck Depression Inventory (BDI-II) at 12 weeks. Secondary outcomes were …

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

Prevalence and association of somatic symptoms in patients with Major Depressive Disorder.

Background: Painful and non-painful somatic symptoms are often reported in patients with depressive disorder. The proper identification of depression-relevant somatic symptoms is important for the accurate diagnosis of depression, development of treatment strategies and measurement of outcome. The objective of this study was to characterize the relationship between somatic symptoms and depression in patients diagnosed with Major Depressive Disorder (MDD), using data from randomized drug trials carried out by a pharmaceutical company. Methods: Pooled 'blinded' data from 2191 patients enrolled in randomized, multicenter, double-blind placebo-controlled studies for the treatment of MDD were analyzed. Somatic symptoms were assessed using the Somatic Symptoms Inventory (SSI) and the Hamilton Depression Rating Scale (HAMD) was used to assess symptoms of depression. Results: The most common som…

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

Psychological therapies for the treatment of mental disorders in low- and middle-income countries affected by humanitarian crises.

Background: People living in humanitarian settings in low- and middle-income countries (LMICs) are exposed to a constellation of stressors that make them vulnerable to developing mental disorders. Mental disorders with a higher prevalence in these settings include post-traumatic stress disorder (PTSD) and major depressive, anxiety, somatoform (e.g. medically unexplained physical symptoms (MUPS)), and related disorders. A range of psychological therapies are used to manage symptoms of mental disorders in this population. Objectives: To compare the effectiveness and acceptability of psychological therapies versus control conditions (wait list, treatment as usual, attention placebo, psychological placebo, or no treatment) aimed at treating people with mental disorders (PTSD and major depressive, anxiety, somatoform, and related disorders) living in LMICs affected by humanitarian crises. Sea…

matched on Somatoform Disorders (mesh)

Short-term psychodynamic psychotherapies for common mental disorders.

Background: Since the mid-1970s, short-term psychodynamic psychotherapies (STPP) for a broad range of psychological and somatic disorders have been developed and studied. Early published meta-analyses of STPP, using different methods and samples, have yielded conflicting results, although some meta-analyses have consistently supported an empirical basis for STPP. This is an update of a review that was last updated in 2006. Objectives: To evaluate the efficacy of STPP for adults with common mental disorders compared with wait-list controls, treatments as usual and minimal contact controls in randomised controlled trials (RCTs). To specify the differential effects of STPP for people with different disorders (e.g. depressive disorders, anxiety disorders, somatoform disorders, mixed disorders and personality disorder) and treatment characteristics (e.g. manualised versus non-manualised thera…

matched on Somatoform Disorders (mesh)

Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis.

Background: Mindfulness-based therapy (MBT) has been used effectively to treat a variety of physical and psychological disorders, including depression, anxiety, and chronic pain. Recently, several lines of research have explored the potential for mindfulness-therapy in treating somatization disorders, including fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome. Methods: Thirteen studies were identified as fulfilling the present criteria of employing randomized controlled trials to determine the efficacy of any form of MBT in treating somatization disorders. A meta-analysis of the effects of mindfulness-based therapy on pain, symptom severity, quality of life, depression, and anxiety was performed to determine the potential of this form of treatment. Findings: While limited in power, the meta-analysis indicated a small to moderate positive effect of MBT (compared to wai…

matched on Somatoform Disorders (mesh)

[Psychotherapy for patients with fibromyalgia syndrome. Systematic review, meta-analysis and guideline].

Background: The scheduled update to the German S3 guidelines on fibromyalgia syndrome (FMS) by the Association of the Scientific Medical Societies ("Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften", AWMF; registration number 041/004) was planned starting in March 2011. Materials and methods: The development of the guidelines was coordinated by the German Interdisciplinary Association for Pain Therapy ("Deutsche Interdisziplinären Vereinigung für Schmerztherapie", DIVS), 9 scientific medical societies and 2 patient self-help organizations. Eight working groups with a total of 50 members were evenly balanced in terms of gender, medical field, potential conflicts of interest and hierarchical position in the medical and scientific fields. Literature searches were performed using the Medline, PsycInfo, Scopus and Cochrane Library databases (until December 2010). Th…

matched on Somatoform Disorders (mesh)

Health anxiety and hypochondriasis: Description and treatment issues highlighted through a case illustration.

Health anxiety and hypochondriasis are serious and debilitating conditions that are poorly understood by health care providers and general public. This is so partly because of the derogatory use of the term hypochondriasis by the general public. There has been a push by mental health professionals in recent years to use the term health anxiety and to use hypochondriasis only for its extreme form. The Internet has become a popular medium, through Web sites and chat rooms, for patients to seek information, reassurance, and exchange of medical information, sometimes of limited veracity. The term cyberchondria has even been coined to describe this phenomenon. The authors review the research literature related to health anxiety and discuss the beneficial treatments of CBT and pharmacology. The utilization of intensive cognitive-behavioral therapy is highlighted with a case illustration.

matched on Hypochondriasis (mesh), Somatoform Disorders (mesh), health anxiety (text)

[Hypochondriasis between health and psychosis].

Considering the lack of clarity in the conceptualisation of hypochondriasis, it is not surprising that the concept is quite heterogeneous and that there are dilemmas in terms of what is encompassed by hypochondriasis and where its boundaries are. Therefore, the aim of this review paper was to contribute towards a more coherent view on hypochondriasis, which would also allow its more adequate classification. The essential features of hypochondriasis were identified as an overvalued idea about the presence of disease, fear that the person has already become seriously ill, reassurance-seeking and other forms of health checking, and disturbances in the perception of bodily sensations and symptoms. These four aspects of hypochondriasis can be assessed dimensionally to ascertain to what extent they characterise each patient. Suggestions have been made to delineate more precisely hypochondriasi…

matched on Hypochondriasis (mesh), Somatoform Disorders (mesh), health anxiety (text)

Alexithymia and cancer pain: the effect of psychological intervention.

Background: Alexithymia is likely to be involved in the pain experience of cancer patients, but the extent to which psychological interventions may modify both pain and alexithymia is unclear. Methods: A group of 52 consecutive cancer patients were enrolled in a 6-month multicomponent psychological intervention trial, and compared to 52 control patients who received standard medical care. Validated scales for pain, alexithymia, coping with disease, illness behavior, psychological distress, and psychosocial functioning were administered at baseline and 6 months later. Results: Pain was strongly associated with alexithymia and several psychological dimensions. Although at baseline patients in the intervention group had worse psychological and somatic health, at follow-up their level of pain intensity, alexithymia, and somatic concerns had significantly improved compared to control patients…

matched on Illness Behavior (mesh)

Synergistic effects of psychological and immune stressors on inflammatory cytokine and sickness responses in humans.

Activation of the innate immune system is commonly accompanied by a set of behavioural, psychological and physiological changes known as 'sickness behaviour'. In animals, infection-related sickness symptoms are significantly increased by exposure to psychosocial stress, suggesting that psychological and immune stressors may operate through similar pathways to induce sickness. We used a double-blind, randomised, placebo-controlled design to examine the effect of acute psychological stress on immune and subjective mood responses to typhoid vaccination in 59 men. Volunteers were assigned to one of four experimental conditions in which they were either injected with typhoid vaccine or saline placebo, and then either rested or completed two challenging behavioural tasks. Typhoid vaccine induced a significant rise in participants' serum levels of interleukin-6 (IL-6) and this response was sign…

matched on Illness Behavior (mesh)

Assessing psychological factors, social aspects and psychiatric co-morbidity associated with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) in men -- a systematic review.

Objective: Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a chronic pain disease with high prevalence rates and substantial health care costs. An interdisciplinary classification system is commonly used (UPOINT) which includes psychosocial factors. Nevertheless, psychosocial influences on CP/CPPS only recently became a research focus. Therefore, we aimed to synthesize the existing data and to identify further research topics. Then, based on our results, diagnosis and treatment can be improved. Methods: In a systematic review conducted according to the PRISMA reporting guidelines we searched different databases (MEDLINE, EMBASE, PsychINFO) using the broad search terms "chronic pelvic pain syndrome AND men". Two raters independently screened the literature and assessed the risk of bias. Results: We included 69 original research articles which considered psychosocial variable…

matched on Somatoform Disorders (mesh)

Why health anxiety needs to be recognised in hospital practice.

Health anxiety, formerly part of hypochondriasis, but now reformulated as excessive concern about health and, by extension, illness, comprises a large proportion of consultations in hospital practice. For too long it has been ignored in practice and not formally treated. This belief is no longer tenable, and in the last few years a number of easily administered psychological treatments have shown consistent benefit that help patients, practitioners and planners of services. A stepped care approach in which physicians and nurses are first helped to identify health anxiety, explain its significance to patients and then, if necessary, administer these treatments in the clinical setting without referral to psychiatric services, is recommended as a way forward. This approach should be embraced in secondary care.

matched on Hypochondriasis (mesh), health anxiety (text), Medically Unexplained Symptoms (keyword)

Development and Validation of the Somatic Symptom Disorder-B Criteria Scale (SSD-12).

Objective: To develop and validate a new self-report questionnaire for the assessment of the psychological features of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition somatic symptom disorder. Methods: The Somatic Symptom Disorder-B Criteria Scale (SSD-12) was developed in several steps from an initial pool of 98 items. The SSD-12 is composed of 12 items; each of the three psychological subcriteria is measured by four items. In a cross-sectional study, the SSD-12 was administered to 698 patients (65.8% female, mean [standard deviation] age = 38.79 [14.15] years) from a psychosomatic outpatient clinic. Item and scale characteristics as well as measures of reliability and validity were determined. Results: The SSD-12 has good item characteristics and excellent reliability (Cronbach α = .95). Confirmatory factor analyses suggested that a three-factorial structure that r…

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

Attribution of somatic symptoms in hypochondriasis.

The misinterpretation of bodily symptoms as an indicator of a serious illness is a key feature of the criteria and the cognitive-behavioural models of hypochondriasis. Previous research suggests that individuals suffering from health anxiety endorse attributions of physical disease, whereas persons with elevated general anxiety have the tendency to attribute psychological causes to their symptoms. However, whether a somatic attribution style is specific to patients with hypochondriasis, as opposed to those with anxiety disorders, has not yet been investigated and is therefore part of the present study. Fifty patients with hypochondriasis, 50 patients with a primary anxiety disorder and 50 healthy participants were presented with nine common bodily sensations and had to spontaneously attribute possible causes to the symptoms. Patients with hypochondriasis differed from patients with anxie…

matched on Hypochondriasis (mesh), Illness Behavior (mesh), Somatoform Disorders (mesh), health anxiety (text), somatic symptom (text)

Effectiveness of a Stepped, Collaborative, and Coordinated Health Care Network for Somatoform Disorders (Sofu-Net): A Controlled Cluster Cohort Study.

Objective: Stepped, collaborative, and coordinated approaches have been proposed as the optimal treatment strategy for somatic symptom and related disorders, but evidence supporting this strategy is lacking. The aim of this study was to assess the effectiveness of a guideline-based health care network for patients who are at high risk of somatoform disorder (Sofu-Net). Methods: In a controlled, prospective, observer-blinded cluster cohort study, patients who were at high risk of somatoform disorder were recruited at 18 primary care practices in the Sofu-Net and at 15 primary care practices that provided care as usual (CAU). The primary outcome at 6-month follow-up was the rate at which the patients received mental health treatment since the establishment of Sofu-Net. The secondary outcomes included the patients' clinical symptom severity. Results: A total of 119 patients in the Sofu-Net …

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