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Diagnostic Criteria PsychNetBack.gif (1523 bytes)

Refer to conditions of use

Hypochondriasis

Unlike conversion disorder where an individual perceives a functional disorder and simply use it to escape from uncomfortable situations, hypochondriacs have no real illness, but is overly obsessed over normal bodily functions. They read into the sensations of these normal bodily functions the presence of a feared disease.

Because of misinterpreting bodily symptoms, the patient becomes preoccupied with ideas or fears of
     having a serious illness.

Appropriate medical investigation and reassurance do not relieve these ideas.

These ideas are not delusional (as in Delusional Disorder) and are not restricted to concern about
     appearance (as in Body Dysmorphic Disorder).

They cause distress that is clinically important or impair work, social or personal functioning.

They have lasted 6 months or longer.

These ideas are do better explained by Generalized Anxiety Disorder, Major Depressive Episode,
    Obsessive-Compulsive Disorder, Panic Disorder, Separation Anxiety or a different Somatoform Disorder.

Specify when With Poor Insight: During most of this episode, the patient does not realize that the preoccupation is excessive or unreasonable.

Associated Features:

None Described

Differential Diagnosis 

Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Major depression
Obsessive Compulsive Disorder
Generalized Anxiety Disorder
Panic Disorder can often cause prominent somatic complaints with no organic basis


Cause:

This is a chronic illness which usually develops in middle age or later. Patients become excessively worried about a physical symptom and cannot shake the idea that something is seriously wrong with them. They are not overtly delusional in this belief, but they hang on to the idea (or worry) with great tenacity despite evidence to the contrary. They seek many tests and much reassurance from their physicians, who tend to get annoyed because the patients are rarely satisfied, complain frequently about their care, and may get worse when they are offered reassurance. The patients often seem highly invested in their own suffering. Males and females are equally affected, and such patients tend to have obsessive and/or paranoid personality traits.

Treatment:

A supportive relationship with a health care provider is the mainstay of treatment. The health care provider should inform the person that no organic disease is present, but that continued medical follow-up will help control the symptoms. The person with hypochondriasis feels real distress, so the symptoms should not be denied or challenged by others.

Counseling and Psychotherapy [ See Counselling Section ]:

The person should be encouraged to discuss other problems rather than reinforcing the symptoms. Family cooperation will be helpful. The person with hypochondriasis and the family need to be helped to find ways to deal with stress other than developing new symptoms.