Hypochondria

Definition

Hypochondria is a belief that real or imagined physical symptoms are signs of a serious illness, despite medical reassurance and other evidence to the contrary.

Alternative Names

Hypochondriasis

Causes, incidence, and risk factors

People with hypochondria are preoccupied with their physical health. They have an unrealistic fear of serious disease that is out of proportion to the actual risk. There is no specific cause of hypochondria, and it occurs equally in men and women.

Symptoms

• Disturbance lasts for at least 6 months (24 weeks)
• Misinterpret symptoms
• No apparent physical disorder that can account for symptoms
• Persistent fear of having a serious illness with no medical reason
• Preoccupied with fear of illness
• Symptoms may shift and change
• Symptoms may be vague or specific (see somatoform pain disorder)

Those who are affected may recognize that their fear of having a serious disease is excessive, unreasonable, or unfounded.

Signs and tests

• Physical examination to rule out illness
• Psychological evaluation to rule out other related disorders

Treatment

It is important to have a supportive relationship with a health care provider. There should be one primary provider to avoid unnecessary tests and procedures.

The health care provider should tell the person that he or she does not have a disease, but that continued medical follow-up will help control the symptoms. People with hypochondria feel real distress, so their symptoms should not be denied or challenged.

Expectations (prognosis)

The disorder is usally long-term (chronic), unless the psychological factors or mood disorder is treated.

Complications

• A real disease may be overlooked because previous complaints were untrue
• Complications from invasive testing to look for the cause of symptoms
• Dependence on pain relievers or sedatives
• Lost time from work due to frequent appointments with health care providers

Calling your health care provider

Call your health care provider if you or your child has symptoms of hypochondria.

References

Moore DP, Jefferson JW. Hypochondriasis. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004:chap 92.

deGruy FV. The somatic patient. In: Rakel RE, ed. Textbook of Family Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 61.

Purcell TB. Somatoform disorders. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2006:chap 111.

Review Date: 8/24/2008

Reviewed by: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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