RESPONSES OF CONSECUTIVE PATIENTS TO REASSURANCE AFTER GASTROSCOPY - RESULTS OF SELF-ADMINISTERED QUESTIONNAIRE SURVEY

Objective: To study the time course and prediction of responses to rea ssurance after gastroscopy showing no serious illness, Design: Selecti on of consecutive patients were assessed before gastroscopy, immediate ly after reassurance, and at follow up at 24 hours, 1 week, 1 month, a nd 1 year, Responses of subgroups of patients identified as high, medi um, and low health anxiety by the health anxiety questionnaire were an alysed. Setting: Endoscopy clinic in a general hospital. Intervention: Oral reassurance that there was nothing seriously wrong.'' Subjects: One consultant physician and 60 patients aged 18-74 referred for gastr oscopy. Main outcome measures: Physician's and patients' ratings of th e extent of the reassurance and patients' ratings of their anxiety abo ut their health and of their illness belief. Results: There was good a greement between the patients and the physician about whether reassura nce had been given, Health anxiety and illness belief decreased marked ly after reassurance, Patients with high health anxiety showed a signi ficant resurgence in their worry and illness belief at 24 hours and 1 week, and these levels were maintained at 1 month and 1 year later, Pa tients with medium levels of health anxiety showed a reduction in worr y and illness belief after reassurance, and this was generally maintai ned during follow up, Patients with low health anxiety maintained low levels of health worry and illness belief throughout the study, Partia l correlation analyses showed that the levels of worry and illness bel ief after reassurance were predicted by the health anxiety questionnai re, This measure also had predictive value beyond that of a measure of general anxiety. Conclusions: Medical reassurance results in a reduct ion of worry about health and of illness belief, but this may be very short term. Measurable individual differences in health anxiety can be used to predict the response to reassurance.