Hypochondriasis

Hypochondriasis is characterized by the fear or belief that one has a serious illness with actual or perceived physical signs or symptoms. This fear or belief is not eliminated by appropriate reassurance from medical professionals or negative diagnostic evaluations. Occasionally the anxiety will be reduced for a short period of time after a negative medical workup, but it inevitably recurs when another symptom is noted. Many people who suffer from this disorder experience a cycle of intrusive thoughts about illness and disease followed by compulsive checking for possible signs of illness in themselves (Fallon et al., 2000). The characteristics that separate hypochondriasis from OCD are the single preoccupation with disease (rather than a shifting symptom content in OCD), the presence of somatic sensations, and the limited insight into the irrationality of the hypochondriacal concerns (Barsky, 1992). In hypochondriasis, the irrational fears are viewed as a rational concern about various signs and symptoms, while obsessive concerns about illness frequently occur in the absence of actual somatic sensations and are viewed as unrealistic (Fallon et al., 1991). The literature suggests that a chronic and an acute transient form of hypochondriasis exist. Acute onset has been associated with a good outcome among of 48 patients studied prospectively; greater improvement was associated with a shorter duration of illness and less depression at baseline (Noyes et al., 1994). Small case reports and clinical trials suggest that patients with hypochondriasis may be helped by treatment with one of the SRIs (Fallon et al., 1993, 1996).

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