Hypochondriasis Health Article

Definition

The primary feature of hypochondriasis is excessive fear of having a serious disease. These fears are not relieved when a medical examination finds no evidence of disease. People with hypochondriasis are often able to acknowledge that their fears are unrealistic, but this intellectual realization is not enough to reduce their anxiety. In order to qualify for a diagnosisof hypochondriasis, preoccupation with fear of disease must cause a great deal of distress or interfere with a person's ability to perform important activities, such as work, school activities, or family and social responsibilities. Hypochondriasis is included in the category of somatoform disorders in the Diagnostic and Statistical Manual of Mental Disorders(DSM-IV-TR), which is the reference handbook that clinicians use to guide the diagnosis of mental disorders. Some experts, however, have argued that hypochondriasis shares many features with obsessive-compulsive disorderor panic disorderand would be more appropriately classified with the anxiety disorders.

Description

The fears of a person with hypochondriasis may be focused on the possibility of a single illness, but more often they include a number of possible conditions. The focus of the fears may shift over time as a person notices a new symptom or learns about an unfamiliar disease. The fears appear to develop in response to minor physical abnormalities, like fatigue, aching muscles, a mild cough or a small sore. People with hypochondriasis may also interpret normal sensations as signs of disease. For instance, an occasional change in heart rate or a feeling of dizziness upon standing up will lead a person with hypochondriasis to fears of heart disease or stroke. Sometimes hypochondriacal fears develop after the death of a friend or family member, or in response to reading an article or seeing a television program about a disease. Fear of illness can also increase in response to stress. Individuals with hypochondriasis visit physicians frequently; and when told there is nothing physically wrong, they are likely to seek a second opinion since their fears are not soothed. Their apparent distrust of their physicians' opinions can cause tensions in doctor-patient relationships, leading to the patient's further dissatisfaction with health care providers. Physicians who regularly see a patient with hypochondriasis may become skeptical about any reported symptom, increasing the danger that a real illness may be overlooked. People with hypochondriasis also run the risk of undergoing unnecessary medical tests or receiving unneeded medications. Although they are usually not physically disabled, they may take frequent sick days from work, or annoy friends and family with constant conversation or complaints about illness, reducing their ability to function effectively in some aspects of life.