Hypochondria

(Hypochondriasis)
  • Definition

    Hypochondria is a health anxiety disorder. It is often chronic. A person with hypochondria is often very anxious about their health. A hypochondriac fears that a real or imagined minor physical symptom is a sign of serious illness. Even when several doctors assure them otherwise, a hypochondriac is convinced that they have a serious disease. Psychiatric counseling and medications can relieve some, if not all, of the anxiety and suffering. Left untreated, hypochondria can be debilitating and affect daily function.
  • Causes

    It is often difficult to identify a specific cause for hypochondria.
  • Risk Factors

    Factors that may increase your risk for getting hypochondria include:
    • Family history of hypochondria
    • Having a serious childhood illness
    • Psychiatric disorders such as depression, anxiety, or personality disorder
    • Physical, sexual, or emotional abuse in childhood
    • Observing violence in childhood
    • Stressful experience with your own or a loved one's illness
    • History of personal traumatic experience
    Brain—Psychological Organ
    Brain Man Face
    Chemical imbalances and traumatic life experiences may contribute to the development of hypochondria.
    Copyright © Nucleus Medical Media, Inc.
  • Symptoms

    Symptoms include:
    • Chronic fear of serious illness
    • Chronic fear that minor symptoms are signs of a serious illness
    • Many physical complaints that often change over time
    • The disorder:
      • Lasts at least six months
      • Causes major distress
      • Interferes with social life or work
    • You may:
      • Check yourself frequently
      • Make many doctor visits, sometimes in the same day
      • Seek repeated tests for the same symptoms
      • Repeatedly research information about specific illnesses and their symptom
      • Change healthcare providers frequently
      • Try multiple herbal remedies or other alternative treatments
  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. If the exam shows no disease, your doctor may begin to suspect hypochondria. If further testing also fails to uncover a known medical condition, your doctor may diagnosis you with hypochondria if:
    • Your fear of illness lasts for at least six months and does not improve with reassurance and negative testing
    • No other psychological disorder is causing your fear
  • Treatment

    Physician Relationship and Monitoring
    Effective treatment involves consistent, supportive care from one doctor, often along with a mental health professional. Finding a healthcare provider who is willing to listen to your concerns, provide support, and avoid needless testing is key to recovery.
    You may feel overwhelmed by your symptoms. They may even seem to control your life. Schedule frequent visits, regardless of symptoms, with one doctor you can trust. Expect your doctor to:
    • Validate your distress
    • Be supportive
    • Direct your attention away from symptoms and focus it on functioning in daily life
    • Discourage a sense of dependency and disability
    • Recommend psychiatric counseling and educational therapy
    Psychological Counseling
    Psychotherapy such as cognitive behavior therapy and behavioral stress management can be effective in treating hypochondria. This involves regular counseling with a psychotherapist to recognize false beliefs, understand anxiety, and stop anxious behaviors.
    Medications
    Antidepressant medicines (such as serotonin reuptake inhibitors, tricyclics antidepressants) may help relieve the symptoms of hypochondria, but there is limited proof.
  • Prevention

    There are no guidelines to prevent hypochondria because the cause is not known.
  • RESOURCES

    American Counseling Association http://www.counseling.org

    American Psychiatric Association http://www.psych.org

    CANADIAN RESOURCES

    Canadian Mental Health Association http://www.ontario.cmha.ca

    Canadian Psychological Association http://www.cpa.ca

    References

    Abramowitz JS, Schwartz SA, et al. A contemporary conceptual model of hypochondriasis. Mayo Clin Proc. 2002;77(12):1323-1330. Available at: http://www.mayoclinicproceedings.org/article/S0025-6196(11)62432-4/fulltext.

    Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Published May 2, 2007. Accessed December 31, 2012.

    Greeven A, van Balkom AJ, et al. Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a randomized controlled trial (Netherlands). Am J Psychiatry. 2007;164:91-99. Available at: http://ajp.psychiatryonline.org/article.aspx?articleid=97690.

    Hypochondriasis. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/disorders/Hypochondriasis/hic%5FHypochondriasis.aspx. Updated July 25, 2011. Accessed December 31, 2012.

    Hypochondriasis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated June 1, 2011. Accessed December 31, 2012.

    Psychotherapies for hypochondriasis. The Cochrane Collaboration website. Available at: http://summaries.cochrane.org/CD006520/psychotherapies-for-hypochondriasis. Published July 8, 2009. Accessed December 31, 2012.

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