Somatization

Hypochondriasis

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Hypochondriasis, Hypochondriac, Illness Anxiety Disorder

  • See Also
  1. Somatoform Disorder
  2. Somatization Risk Factors
  3. Somatization Symptoms
  4. Somatization Management
  5. Somatoform Disorder Management Pitfalls
  6. Somatization Disorder
  7. Conversion Disorder
  8. Pain Disorder
  • Epidemiology
  1. Peak onset: ages 20 to 40 years
  2. Prevalence: 2 to 7% in U.S. primary care settings
  • Diagnosis
  • DSM-V - Illness Anxiety Disorder (replaces Hypochondriasis)
  1. Meets criteria and is a subset of Somatic Symptom Disorder
  2. Preoccupation with either contracting or having a serious medical disorder
  3. SubTypes
    1. Care-seeking subtype
    2. Care-avoidant subtype
  • Diagnosis
  • DSM IV - Hypochondriasis
  1. Must meet criteria for a Somatoform Disorder
    1. Unexplained physical symptoms
    2. Not due to condition of Secondary Gain (Malingering or Factitious Disorder)
    3. Causes dysfunction
  2. Specific criteria for Hypochondriasis
    1. Nondelusional preoccupation for at least 6 months
    2. Fixation or fear of a serious or life-threatening medical condition
  • Symptoms
  1. Patient preoccupied with mild symptoms
    1. Believes illness is serious or life-threatening
    2. Angrily rejects reassurance of good health
    3. Demands further evaluation and treatment
    4. Shops from physician to physician
  2. Hyperalert to symptoms
    1. Presents symptoms in minute detail
    2. "Knows what the trouble is"
    3. Wants physician to concur with their self-diagnosis
  • Associated conditions
  1. Schizophrenia
  2. Major Depression
  3. Dysthymic Disorder
  4. Organic Brain Syndrome
  • Differential Diagnosis
  1. Somatoform Disorder
  2. Chronic Factitious Disorder
  3. Malingering
  • Management
  1. See Somatoform Disorder Management
  • Course
  1. Chronic life-long illness
  • References
  1. Tomb (1988) Psychiatry, Williams & Wilkins, p. 96-7