hypochondriasis


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Related to hypochondriasis: somatization disorder

Hypochondriasis

 

Definition

Hypochondriasis is a mental disorder characterized by excessive fear of or preoccupation with a serious illness, despite medical testing and reassurance to the contrary. It was formerly called hypochondriacal neurosis.

Description

Although hypochondriasis is often considered a disorder that primarily affects adults, it is now increasingly recognized in children and adolescents. In addition, hypochondriasis may develop in elderly people without previous histories of health-related fears. The disorder accounts for about 5% of psychiatric patients and is equally common in men and women.

Causes and symptoms

The causes of hypochondriasis are not precisely known. Children may have physical symptoms that resemble or mimic those of other family members. In adults, hypochondriasis may sometimes reflect a self-centered character structure or a wish to be taken care of by others; it may also have been copied from a parent's behavior. In elderly people, hypochondriasis may be associated with depression or grief. It may also involve biologically based hypersensitivity to internal stimuli.
Most hypochondriacs are worried about being physically sick, although some express fear of insanity. The symptoms reported can range from general descriptions of a specific illness to unusual complaints. In many instances the symptoms reflect intensified awareness of ordinary body functions, such as heartbeat, breathing, or stomach noises. It is important to understand that a hypochondriac's symptoms are not "in the head" in the sense of being delusional. The symptoms are real, but the patient misinterprets bodily functions and attributes them to a serious or even lethal cause.

Diagnosis

The diagnosis is often complicated by the patient's detailed understanding of symptoms and medical terminology from previous contacts with doctors. If a new doctor suspects hypochondriasis, he or she will usually order a complete medical workup in order to rule out physical disease.
Psychological evaluation is also necessary to rule out other disorders that involve feelings of anxiety or complaints of physical illness. These disorders include depression, panic disorder, and schizophrenia with somatic (physical) delusions. The following features are characteristic of hypochondriasis:
  • The patient is not psychotic (out of touch with reality or hallucinating).
  • The patient gets upset or blames the doctor when told there is "nothing wrong," or that there is a psychological basis for the problem.
  • There is a correlation between episodes of hypochondriacal behavior and stressful periods in the patient's life.
  • The behavior has lasted at least six months.
Evaluation of children and adolescents with hypochondriasis should include the possibility of abuse by family members.

Treatment

The goal of therapy is to help the patient (and family) live with the symptoms and to modify thinking and behavior that reinforces hypochondriacal symptoms. This treatment orientation is called supportive, as distinct from insight-oriented, because hypochondriacs usually resist psychological interpretations of their symptoms. Supportive treatment may include medications to relieve anxiety. Some clinicians look carefully for "masked" depression and treat with antidepressants.
Follow-up care includes regular physical check-ups, because about 30% of patients with hypochondriasis will eventually develop a serious physical illness. The physician also tries to prevent unnecessary medical testing and "doctor shopping" on the patient's part.

Prognosis

From 33-50% of patients with hypochondriasis can expect significant improvement from the current methods of treatment.

Resources

Books

Eisendrath, Stuart J. "Psychiatric Disorders." In Current Medical Diagnosis and Treatment, 1998, edited by Stephen McPhee, et al., 37th ed. Stamford: Appleton & Lange, 1997.

Key terms

Somatoform disorder — A category of psychiatric disorder characterized by conversion of emotional distress into physical symptoms or by symptoms of physical illness that have no discernible organic cause. Hypochondriasis is classified as a somatoform disorder.
Supportive therapy — Any form of treatment intended to relieve symptoms or help the patient live with them rather than attempt changes in character structure.

hypochondriasis

 [hi″po-kon-dri´ah-sis]
a somatoform disorder marked by a preoccupation with one's health bodily functions and by exaggeration of normal sensations (such as heart beats, sweating, peristaltic action, and bowel movements) and minor complaints (such as a runny nose, minor aches and pains, or slightly swollen lymph nodes) into a strong belief of serious problems needing medical attention. Negative results of diagnostic evaluations and reassurance by health care providers only increase the patient's anxious concern about his health, although the concern is not of delusional intensity. adj., adj hypochon´driac, hypochondri´acal.

hy·po·chon·dri·a·sis

(hī'pō-kon-drī'ă-sis),
A morbid concern about one's own health and exaggerated attention to any unusual bodily or mental sensations; a delusion that one is suffering from some disease for which no physical basis is evident.
[fr. hypochondrium, regarded as the site of hypochondria, + G. -iasis, condition]

hypochondriasis

/hy·po·chon·dri·a·sis/ (-kon-dri´ah-sis) a somatoform disorder characterized by a preoccupation with bodily functions and the interpretation of normal sensations or minor abnormalities as indications of serious problems needing medical attention.hypochon´driachypochondri´acal

hypochondriasis

(hī′pə-kən-drī′ə-sĭs)
n. pl. hypochondria·ses (-sēz′)

hypochondriasis

[hī′pōkəndrī′əsis]
Etymology: Gk, hypo + chondros, cartilage, osis, condition
a chronic abnormal concern about the health of the body. It is characterized by extreme anxiety, depression, and an unrealistic interpretation of real or imagined physical symptoms as indications of a serious illness or disease despite rational medical evidence that no disorder is present. The condition is caused by some unresolved intrapsychic conflict and may involve a specific organ, such as the heart, lungs, or eyes, or several body systems at various times or simultaneously. In severe cases the distorted body-mind relationship is so strong that actual symptoms and disease may develop. Treatment usually consists of psychotherapy to uncover the underlying emotional conflict. Also called hypochondria.

hypochondriasis

Hypochondria Psychiatry An exaggerated concern of diseases or medical disorders that can result in psychosomatic Sx; excessive concern for perceived bodily Sx despite assurance that such concern is unfounded. See Medical school syndrome.

hy·po·chon·dri·a·sis

(hī'pō-kŏn-drī'ă-sis)
A morbid concern about one's own health and exaggerated attention to any unusual bodily or mental sensations; a delusion that one is suffering from some disease for which no physical basis is evident.
Synonym(s): hypochondria.
[fr. hypochondrium, regarded as the site of hypochondria, + G. -iasis, condition]

hy·po·chon·dri·a·sis

(hī'pō-kŏn-drī'ă-sis)
A morbid concern about one's own health and exaggerated attention to any unusual bodily or mental sensations; delusion one is suffering from some disease for which no physical basis is evident.
Synonym(s): hypochondria.
[fr. hypochondrium, regarded as the site of hypochondria, + G. -iasis, condition]

hypochondriasis (hī´pōkondrī´-əsis),

References in periodicals archive ?
A loss of such power could actually produce a number of symptoms, ranging from the dullness of feeling that afflicted Mill to an ungoverned sensitivity and irritability that characterized that crippling male malady, hypochondriasis, a form of abnormal excitement turned inward, and which seems quite apparently to afflict the protagonist in Tennyson's poem.
Evatt's fantasy was that all good objects were transitory, and he was haunted by images of death expressed in his fear of flying and his hypochondriasis.
One subgroup responded normally to psychological tests except for high denial, and the other had high scores for anxiety and depression accompanied by introversion, neuroticism, and illness behavior alterations with high degrees of hypochondriasis and disease conviction, dysphoria, and irritability.
This research is consistent with the idea that hypochondriasis should be considered for inclusion as an anxiety disorder in DSM-V--perhaps as 'health anxiety disorder.
Morbid preoccupations, health anxiety and reassurance: a cognitive-behavioural approach to hypochondriasis.
During the 17th and 18th centuries, a variety of disorders such as hypochondriasis, hysteria, dyspepsia, and "gas and spleen disease" (vapors) were included under the general heading of "nervous disorder," a term created by Briefe in 1603, that was subsequently replaced with the vague term "nervous temperament.
It sounded as if he might be suffering from "manflu" this illness is a cold when it occurs in women and children but is accompanied by much more moaning, lying around in bed and hypochondriasis in adult males.
Individuals scoring high on the hypochondriasis scale tend to worry excessively about their health, to the point that it dominates their lives and seriously restricts their activities, potentially resulting in increased risk of injury.
Hypochondriasis is generated and outcomes could be lethal.
The first psychiatry textbook published in the United States said that masturbation "produces seminal weakness, impotence, dysury, tabes dorsalis, pulmonary consumption, dyspepsia, dimness of sight, vertigo, epilepsy, hypochondriasis, loss of memory, manalgia, fatuity and death.
Chinese versions of the international version of the Mental Status Questionnaire and the Hypochondriasis Scale.
Table 2 Means and Standard Deviations of MMPI-2 Results of the High-Test-Anxious LD Group (N = 24) Compared to the Non-Test-Anxious LD Group (N = 30) High-Test-Anxious Non-Test-Anxious Group Group Variable Mean SD Mean SD t (1) MMPI-2 Hypochondriasis 16.