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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

You will be asked 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 medications (such as serotonin reuptake inhibitors and tricyclic antidepressants) may help relieve the symptoms of hypochondria, but there is limited evidence.

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. Accessed November 11, 2014.

Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Updated August 12, 2010. Accessed November 11, 2014.

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. Accessed November 11, 2014.

Hypochondriasis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 29, 2014. Accessed November 11, 2014.

Psychotherapies for hypochondriasis. The Cochrane Collaboration website. Available at: http://summaries.cochrane.org/CD006520/psychotherapies-for-hypochondriasis. Published July 8, 2009. Accessed November 11, 2014.

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