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New Treatments for Hypochondriasis

DSM IV Criteria

Preoccupation with fear of having a serious disease, based on misinterpretation of symptoms.

The patient is not reassured by a negative medical evaluation.

Symptoms are not related to delusions, or restricted to specific concern about appearance.

The disorder results in significant functional impairment.

Duration is greater than 6 months.

Symptoms are not accounted for by another mental disorder.

Clinical Features of Hypochondriasis

Despite clinical, diagnostic or laboratory evaluation, the patient is not reassured

Doctor shopping is common, and complaints are often vague and ambiguous.

Repeated diagnostic procedures may result in unrelated medical complications.

Epidemiology and Classification of Hypochondriasis

The prevalence ranges from 4 - 9%.

Most frequent between age 20 to 30 years, and there is no sex predominance

Hypochondriasis "with poor insight" is present if the patient fails to recognize concern about health as excessive or unreasonable.

Differential Diagnosis

Major depression, obsessive compulsive disorder, generalized anxiety disorder, and panic disorder can often cause prominent somatic complaints with no organic basis.

Medical conditions that can produce varied symptoms.

Treatment