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 ?
In the women's group, the high association found between the OCD and HYP intrusions supports the assumption that a close relationship exists between OCD and Hypochondriasis (e.
37 * The three groups were the emotional disturbance group (SG), normal group (NG), and clinical inpatient group (HG); the eight scales were Hypochondriasis (Hs), Hysteria (Hy), Schizophrenia (Sc), Adolescent-low aspirations (A-las), Adolescent-health concerns (A-hea), Adolescent-low self-esteem (A-lse), Adolescent-school problems (A-sch), and Immaturity (IMM).
The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis.
Meaning, misinterpretations, and medicine: A cognitive-behavioral approach to understanding health anxiety and hypochondriasis.
Hypochondriasis is most common between the ages of 20-30 and may be a complication of other psychological disorders such as depression or anxiety.
The relevance of early parental experiences to adult dependency, hypochondriasis and utilization of primary physicians.
SD= Somatization Disorder, CD= Conversion Disorder, PD= Pain Disorder, Hypochondriasis, USD= Undifferentiated somatoform disorder, BDD= Body Dysmorphic Disorder
Medicinal indications for the use of valerian include insomnia (Bent 2006), restlessness and anxiety (Thomsen 2009), dysmenorrhea (Mirabi 2011), nervous headache (Sarris 2010), nervous tension (Mills 2000), hypochondriasis (BHP 1976), symptoms of menopause (Wyk 2009), nervous palpitations (Weiss 1988), nervous asthma (AHP 1999), benzodiazepine withdrawal (Head 2009b), restless leg syndrome (Cuellar 2009), rheumatic pains (BHP 1976), ADHD (AHP 1999), migraine (Thomsen 2009), chorea (Bone 2003), intestinal colic (BHP 1976), cholecystitis (Hechtman 2012), epilepsy (Griggs 1997), obsessive compulsive disorder (Pakseresht 2011), anxiety and alterations in hyperthyroidism (Hechtman 2012).
Se realizo una busqueda sistematica por medio de las motores de busqueda Pubmed, Embase y Lilacs; se revisaron estudios clinicos realizados de 1992 a 2012 en menores de 18 anos con criterios de busqueda que incluyeron: somatoform disorder (somatization disorder, somatization disorders briquet syndrome, pain disorder), conversion disorder (conversion disorders, hysteria, conversion reaction globus hystericus), hypochondriasis.
Somatic fixation can occur not only in cases in which the illness has traditionally been thought to have a large psychological component, such as hypochondriasis (excessive preoccupation about a disease), somatization disorder (psychiatric diagnosis applied to patients who persistently complain of varied physical symptoms that have no identifiable physical origin), and psychosomatic illness (the illness may be emotional or mental in origin but have physical symptoms), but also in conditions like chronic pain, cancer, diabetes, or sickle cell disease.