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Hypochondriasis - Hypochondriasis Symptom, Cause, Treatment
Hypochondriasis is a mental disorder characterized by excessive fear of or preoccupation with a serious illness, despite medical testing and reassurance to the contrary. It was formerly called hypochondriacal neurosis. person interprets physical symptoms and sensations as signs of a serious medical illness despite medical reassurance that they are not. Hypochondriasis may develop in elderly people without previous histories of health-related fears. The disorder accounts for about 5% of psychiatric patients and is equally common in men and women. Hypochondriasis and the other somatoform disorders are among the most difficult and most complex psychiatric disorders to treat in the medical setting.
Symptoms of Hypochondriasis
There are many symptoms of Hypochondriasis. Some are here
- The primary symptom of hypochondriasis is preoccupation with fears of serious physical illness or injury.
- Preoccupation with fears of having, or the idea that one has, a serious disease based on the person's misinterpretation of bodily symptoms.
- The belief in the first category is not of delusional intensity and is not restricted to a circumscribed concern about appearance.
- The symptoms are real, but the patient misinterprets bodily functions and attributes them to a serious or even lethal cause.
- The duration of the disturbance is at least 6 months.
- Because of misinterpreting bodily symptoms, the patient becomes preoccupied with ideas or fears of having a serious illness.
- These ideas are not delusional (as in Delusional Disorder ) and are not restricted to concern about appearance (as in Body Dysmorphic Disorder).
Causes of Hypochondriasis
This is a chronic illness which usually develops in middle age or later. Patients become excessively worried about a physical symptom and cannot shake the idea that something is seriously wrong with them. They are not overtly delusional in this belief, but they continue to worry despite evidence to the contrary. Other causes are
- A cognitive model of hypochondriasis suggests that patients misinterpret bodily symptoms by augmenting and amplifying their somatic sensations. Patients also appear to have lower-than-usual thresholds for, and tolerance of, physical discomfort.
- The social learning theory frames hypochondriasis as a request for admission to the sick role made by a person facing seemingly insurmountable and insolvable problems.
- The psychodynamic theory implies that aggressive and hostile wishes toward others are transferred via repression and displacement into physical complaints.
- They seek many tests and much reassurance from their doctor. The patients often seem highly invested in their own suffering.
- Stressful life situations may overwhelm a person and contribute to the development of generalized anxiety. A history of excessive worry may also be a predisposing factor in its development
Treatment of Hypochondriasis
A person with this disease has real symptoms even if there is no underlying illness. The first goal of treatment is to reduce these symptoms. A supportive relationship with a clinician is the main objective of treatment. The clinician should inform the person that no organic disease is present, but that continued medical follow-up will help control the symptoms. The person with hypochondrias feels real distress, so the symptoms should not be denied or challenged by others. The treatment list of Hypochondriasis are includes
Psychotherapy
- Several authors have suggested a cognitive-educational approach to understand the development of the severe anxiety associated with hypochondriasis and the factors that maintain the long-term anxiety. Randomized controlled trials now suggest that cognitive-behavioral therapy is efficacious in the treatment of hypochondriasis and may be the recommended treatment for patients with hypochondriasis.
- In a corollary vein, controlled studies of patients with noncardiac chest pain show that patients who accept psychological factors as the major cause of their symptoms report a significant decrease in pain.
- Exposure and response prevention and cognitive therapy have been shown to be equally valuable in the treatment of patients with hypochondriasis.
- Group therapy interventions have gained prominence in recent years, including a cognitive-educational approach.
- Psychotherapy can counter maladaptive iatrogenic beliefs.
Pharmacotherapy
- Off-label usage is being studied for primary hypochondriasis. Initial case reports reported positive effects from fluoxetine, clomipramine, fluvoxamine, and imipramine.
- Pharmacotherapy has also been directed at anxiety or depression coexisting with hypochondriasis. In controlled trials, benzodiazepines, imipramine, phenelzine, propranolol, and alprazolam were found to decrease somatic symptoms in anxious patients.
- Treatment of delusional disorder, somatic type (monosymptomatic hypochondriacal psychosis or parasitosis) has been largely successful via pharmacotherapy.
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