https://en.wikipedia.org/wiki/Hypochondriasis
Hypochondriasis, also known as hypochondria, health anxiety or illness anxiety disorder, refers .... Common symptoms include headaches; abdominal, back, joint, rectal, ... Hypochondria is currently considered a psychosomatic disorder, as in a ... ribs and navel" from hypo ("under") and khondros, or cartilage (of the sternum).
Hypochondriasis
From Wikipedia, the free encyclopedia
Hypochondriasis, also known as
hypochondria,
health anxiety or
illness anxiety disorder,
refers to worry about having a serious illness. This debilitating
condition is the result of an inaccurate perception of the condition of
body or mind despite the absence of an actual medical condition.
[1] An individual suffering from hypochondriasis is known as a
hypochondriac.
Hypochondriacs become unduly alarmed about any physical or
psychological symptoms they detect, no matter how minor the symptom may
be, and are convinced that they have, or are about to be diagnosed with,
a serious illness.
[2]
Often, hypochondria persists even after a physician has evaluated a
person and reassured them that their concerns about symptoms do not have
an underlying medical basis or, if there is a medical illness, their
concerns are far in excess of what is appropriate for the level of
disease. Many hypochondriacs focus on a particular symptom as the
catalyst of their worrying, such as gastro-intestinal problems,
palpitations, or
muscle fatigue. To qualify for the diagnosis of hypochondria the symptoms must have been experienced for at least 6 months.
[3]
The
DSM-IV-TR defines this disorder, "Hypochondriasis", as a
somatoform disorder[4] and one study has shown it to affect about 3% of the visitors to primary care settings.
[5] The newly published
DSM-5 replaces the diagnosis of hypochondriasis with the diagnoses of "
Somatic Symptom Disorder" and "
Illness Anxiety Disorder".
[6]
Hypochondria is often characterized by fears that minor bodily or
mental symptoms may indicate a serious illness, constant
self-examination and
self-diagnosis, and a preoccupation with one's body. Many individuals with hypochondriasis express doubt and disbelief in the doctors'
diagnosis,
and report that doctors’ reassurance about an absence of a serious
medical condition is unconvincing, or short-lasting. Additionally, many
hypochondriacs experience elevated blood pressure, stress, and anxiety
in the presence of doctors or while occupying a medical facility, a
condition known as "
white coat syndrome".
Many hypochondriacs require constant reassurance, either from doctors,
family, or friends, and the disorder can become a disabling torment for
the individual with hypochondriasis, as well as his or her family and
friends.
[7]
Some hypochondriacal individuals completely avoid any reminder of
illness, whereas others frequently visit medical facilities, sometimes
obsessively. Other victims of this disease will never speak about it.
[citation needed]
Characteristics
Hypochondriasis is categorized as a somatic amplification disorder—a disorder of "perception and cognition"
[1]—that
involves a hyper-vigilance of situation of the body or mind and a
tendency to react to the initial perceptions in a negative manner that
is further debilitating. Hypochondriasis manifests in many ways. Some
people have numerous intrusive thoughts and physical sensations that
push them to check with family, friends, and physicians. For example, a
person who has a minor cough may think that they have tuberculosis.
[8]
Or sounds produced by organs in the body, such as those made by the
intestines, might be seen as a sign of a very serious illness to
patients dealing with hypochondriasis.
[citation needed]
Other people are so afraid of any reminder of illness that they will
avoid medical professionals for a seemingly minor problem, sometimes to
the point of becoming neglectful of their health when a serious
condition may exist and go undiagnosed. Yet others live in despair and
depression, certain that they have a life-threatening disease and no
physician can help them. Some consider the disease as a punishment for
past misdeeds.
[9]
Hypochondriasis is often accompanied by other psychological disorders.
Bipolar disorder,
clinical depression,
obsessive-compulsive disorder (OCD),
phobias, and
somatization disorder are the most common accompanying conditions in people with hypochondriasis, as well as a
generalized anxiety disorder diagnosis at some point in their life.
[10]
Many people with hypochondriasis experience a cycle of intrusive
thoughts followed by compulsive checking, which is very similar to the
symptoms of
obsessive-compulsive disorder.
However, while people with hypochondriasis are afraid of having an
illness, patients with OCD worry about getting an illness or of
transmitting an illness to others.
[9] Although some people might have both, these are distinct conditions.
[citation needed]
Patients with hypochondriasis often are not aware that depression and
anxiety produce their own physical symptoms, and mistake these symptoms
for manifestations of another mental or physical disorder or disease.
For example, people with depression often experience changes in appetite
and weight fluctuation, fatigue, decreased interest in sex and
motivation in life overall. Intense anxiety is associated with rapid
heartbeat, palpitations, sweating, muscle tension, stomach discomfort,
dizziness, and numbness or tingling in certain parts of the body (hands,
forehead, etc.).
[citation needed]
In some cases, hypochondriasis responds well to
antipsychotics, particularly the newer
atypical antipsychotic medication.
[11][12]
If a person is ill with a medical disease such as
diabetes or
arthritis, there will often be psychological consequences, such as depression. Some even report being
suicidal.
In the same way, someone with psychological issues such as depression
or anxiety will sometimes experience physical manifestations of these
affective fluctuations, often in the form of medically unexplained
symptoms. Common symptoms include headaches; abdominal, back, joint,
rectal, or urinary pain; nausea; fever and/or night sweats; itching;
diarrhea; dizziness; or balance problems. Many people with
hypochondriasis accompanied by medically unexplained symptoms feel they
are not understood by their physicians, and are frustrated by their
doctors’ repeated failure to provide symptom relief.
[citation needed]
Diagnosis
The
ICD-10 defines hypochondriasis as follows:
- A. Either one of the following:
-
- A persistent belief, of at least six months' duration, of the
presence of a maximum of two serious physical diseases (of which at
least one must be specifically named by the patient).
- A persistent preoccupation with a presumed deformity or disfigurement (body dysmorphic disorder).
- B. Preoccupation with the belief and the symptoms causes persistent
distress or interference with personal functioning in daily living, and
leads the patient to seek medical treatment or investigations (or
equivalent help from local healers).
- C. Persistent refusal to accept medical advice that there is no
adequate physical cause for the symptoms or physical abnormality, except
for short periods of up to a few weeks at a time immediately after or
during medical investigations.
- D. Most commonly used exclusion criteria: not occurring only during any of the schizophrenia and related disorders (F20-F29, particularly F22) or any of the mood disorders (F30-F39).
The
DSM-IV defines hypochondriasis according to the following criteria:
[4]
A. Preoccupation with fears of having, or the idea that one has, a
serious disease based on the person's misinterpretation of bodily
symptoms.
B. The preoccupation persists despite appropriate medical evaluation and reassurance.
C. The belief in Criterion A is not of delusional intensity (as in Delusional Disorder, Somatic Type) and is not restricted to a circumscribed concern about appearance (as in Body Dysmorphic Disorder).
D. The preoccupation causes clinically significant distress or
impairment in social, occupational, or other important areas of
functioning.
E. The duration of the disturbance is at least 6 months.
F. The preoccupation is not better accounted for by Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, a Major Depressive Episode, Separation Anxiety, or another Somatoform Disorder.
The newly published
DSM-5 replaces the diagnosis of hypochondriasis with "illness anxiety disorder".
[6]
Cause
Hypochondria is currently considered a
psychosomatic disorder, as in a
mental illness with
physical symptoms.
[13] Cyberchondria is a
colloquial term for hypochondria in individuals who have researched medical conditions on the
Internet.
The media and the Internet often contribute to hypochondria, as
articles, TV shows and advertisements regarding serious illnesses such
as
cancer and
multiple sclerosis
often portray these diseases as being random, obscure and somewhat
inevitable. Inaccurate portrayal of risk and the identification of
non-specific symptoms as signs of serious illness contribute to exacerbating the hypochondriac’s fear that they actually have that illness.
[citation needed]
Major disease outbreaks or predicted
pandemics
can also contribute to hypochondria. Statistics regarding certain
illnesses, such as cancer, will give hypochondriacs the illusion that
they are more likely to develop the disease.
[citation needed]
Overly protective caregivers and an excessive focus on minor health
concerns have been implicated as a potential cause of hypochondriasis
development.
[14]
It is common for serious illnesses or deaths of family members or
friends to trigger hypochondria in certain individuals. Similarly, when
approaching the age of a parent's premature death from disease, many
otherwise healthy, happy individuals fall prey to hypochondria. These
individuals believe they are suffering from the same disease that caused
their parent's death, sometimes causing panic attacks with
corresponding symptoms.
[citation needed]
Family studies of hypochondriasis do not show a genetic transmission
of the disorder. Among relatives of people suffering from
hypochondriasis only somatization disorder and generalized anxiety
disorder were more common than in average families.
[9]
Other studies have shown that the first degree relatives of patients
with OCD have a higher than expected frequency of a somatoform disorder
(either hypochondriasis or
body dysmorphic disorder).
[15]
Treatment
Most research indicates that
cognitive behavioral therapy (CBT) is an effective treatment for hypochondriasis.
[16][17] Much of this research is limited by methodological issues.
[17] A small amount of evidence suggests that
selective serotonin reuptake inhibitors can also reduce symptoms, but further research is needed.
[18]
Etymology
Among the
regions of the abdomen, the
hypochondrium is the uppermost part. The word derives from the
Greek term ὑποχόνδριος
hypokhondrios, meaning "of the soft parts between the ribs and navel" from
hypo ("under") and
khondros, or
cartilage (of the
sternum).
Hypochondria in
Late Latin meant "the abdomen".
[19]
The term
hypochondriasis for a state of disease without real cause reflected the
ancient belief that the viscera of the hypochondria were the seat of
melancholy and sources of the vapor that caused morbid feelings.
[20]
Until the early 18th century, the term referred to a "physical disease
caused by imbalances in the region that was below your rib cage" (i.e.,
of the stomach or
digestive system). For example,
Robert Burton's
The Anatomy of Melancholy (1621) blamed it "for everything from 'too much spittle' to 'rumbling in the guts'".
[21]
Immanuel Kant discussed hypochondria in his 1798 book, Anthropology like this:
The disease of the hypochondriac consists in this: that certain
bodily sensations do not so much indicate a really existing disease in
the body as rather merely excite apprehensions of its existence: and
human nature is so constituted – a trait which the animal lacks – that
it is able to strengthen or make permanent local impressions simply by
paying attention to them, whereas an abstraction – whether produced on
purpose or by other diverting occupations – lessen these impressions, or
even effaces them altogether.
See also
