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The Association Between Benign Fasciculations and Health Anxiety: A Report of Two Cases and a Systematic Review of the Literature

机译：良性识别与健康焦虑的关联：两种情况的报告和对文献的系统审查

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Background: Benign fasciculation syndrome (BFS) is characterized by persistent spontaneous contractions of muscle fibers in the absence of a pathological cause. Patients with BFS often have concerns around having motor neuron disease, in some cases fulfilling the criteria for health anxiety disorder. Research on how BFS and health anxiety relate to one another and how they should be optimally managed together is sparse. Objective: We report two cases of BFS associated with health anxiety. We also review the literature on the association between BFS and health anxiety. Methods: We systematically reviewed the literature using MEDLINE, Embase, PsycINFO, and Open Grey for studies investigating benign fasciculations and anxiety up to August 2018. Results: Both cases were successfully treated for health anxiety disorder with cognitive-behavioral therapy (CBT) and antidepressant medication. We identified eight studies that met the inclusion criteria, describing a total of 384 patients. Most studies were of moderate quality. Patients with BFS tended to be male and in their 30s or 40s. There was an overrepresentation of clinicians. Anxiety symptoms were common and frequently coexisted alongside fasciculations. Health anxiety was overwhelmingly focused around motor neuron disease. Conclusion: A proportion of individuals with BFS experience anxiety around having motor neuron disease to the point of developing health anxiety disorder. A bidirectional relationship may exist between BFS and health anxiety disorder. Clinicians should be alert to the possibility of health anxiety disorder in patients with BFS and have a low threshold to refer for psychiatric assessment. There is support for the role of psychological therapy, especially CBT, as well as pharmacotherapy, in the form of antidepressant medication. In severe or treatment-refractive cases, combined treatment may be indicated.
机译：背景：良性束态综合征（BFS）的特征在于在没有病理原因的情况下肌纤维的持续自发性收缩。在某些情况下，BFS患者通常涉及具有运动神经元疾病的疑虑，符合健康焦虑症的标准。研究BFS和健康焦虑互相互相涉及的问题以及它们应该如何最佳地管理稀疏。目的：我们报告了两种与健康焦虑相关的BFS病例。我们还审查了BFS与健康焦虑之间的关联的文献。方法：我们使用Medline，Embase，Psycinfo系统地系统地审查了文献，并为2018年8月调查良性诡诈和焦虑的研究进行了开放的灰色。结果：两种病例已成功治疗健康焦虑症（CBT）和抗抑郁药药物。我们确定了八项研究，符合纳入标准，描述了384名患者。大多数研究具有适度的质量。患有BFS的患者倾向于是男性和30多岁或40多岁。临床医生有过高陈述。焦虑症状是常见的，经常共存在框架中。健康焦虑绝对聚焦于运动神经元疾病。结论：具有BFS的个体的比例体验焦虑与运动神经元疾病到发育健康焦虑症的程度。 BFS和健康焦虑症之间可能存在双向关系。临床医生应警惕BFS患者健康焦虑症的可能性，并且具有低门槛，以参考精神病学评估。以抗抑郁药物的形式支持心理治疗，特别是CBT以及药物治疗的作用。在严重或治疗屈光壳中，可以表明组合治疗。

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