Hypochondriasis

15/12/2013 by admin | Psychiatry

Definition:refers to excessive preoccupation or worry about having a serious illness. Hypochondriacs become unduly alarmed about any physical symptoms they detect, no matter how minor the symptom may be… these pts often experience depression and anxiety, which then produce physical symptoms that might be mistaken for signs of a serious medical disease (rapid heart beat, palpitations, sweating, muscle tension, stomach discomfort, and numbness or tingling).

Many individuals with hypochondriasis express doubt and disbelief in the doctors’ diagnosis, and report that doctors’ reassurance about an absence of a serious medical condition is unconvincing, or un-lasting. Hypochondriasis is often accompanied by other psychological disorders. Clinical depressionobsessive-compulsive disorder (also known as OCD), phobias and somatization disorder are the most common accompanying conditions in people with hypochondriasis, as well as a generalized anxiety disorder diagnosis at some point in their life

Classification / type of disease:

Epidemiology: usually seen between 20-30yo. More common in men>women.

Presenting symptoms / signs:  

Diagnostic criteria:

  • Preoccupation with fears of having, or the idea that one has, a serious disease based on the person’s misinterpretation of bodily symptoms.
  • The preoccupation persists despite appropriate medical evaluation and reassurance.
  • The belief in the first criteria is not of delusional intensity and is not restricted to a circumscribed concern about appearance (as in Body Dysmorphic Disorder).
  • The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • The duration of the disturbance is at least 6 months.
  • The preoccupation is not better accounted for by Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, a Major Depressive Episode, Separation Anxiety, or another Somatoform Disorder.

These pts typically have poor insight and do not understand that their concern or anxiety about having a serious illness is excessive or unreasonable.

Aetiology:

  • Cyberchondria is a colloquial term for hypochondria in individuals who have researched medical conditions on the Internet, plus on TV, magazines etc..
  • Pandemics cause certain individuals to have hypochondrial responses.
  • Loss of close friend or family member
  • High levels of stress

Pathophysiology:

Transmission:

Treatment:

  • CBT
  • SSRIs
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