The hypochondria Is a disorder in which anxiety focuses on the possibility of having a serious illness. That threat seems so real that even the doctors' claim that there are no real diseases can reassure them.
The main characteristic of hypochondria is the concern about having a disease. That is, the main problem is the anxiety . In this article I will explain your causes, symptoms, treatment, diagnosis and much more.
The concern is centered on the bodily symptoms, which are interpreted as a sign of illness or physical problem. They may be:
- Heart rate.
- Breathing frequency.
- Cough.
- Dolores.
- Fatigue.
Firstly, the person with hypochondria begins to go to family doctors and when they discard the real diseases, they can go to mental health professionals.
A common feature is that although doctors reassure themselves that there is no disease, the person is only reassured in the short term. Soon after, he usually returns to other doctors believing that the previous ones failed in the diagnosis or something happened to them.
On the other hand, this disorder co-occurs (is often comorbid) With panic disorder , Sharing these features:
- Characteristics of the personality of the person.
- Age of appearance.
- Family transmission patterns (heritability).
Causes of hypochondriasis
Most hypochondriac researchers have agreed that it is a problem of perception or cognition with emotional contributions.
In addition, they influence genetic characteristics and the environment of the person. Therefore, it is believed that its causes are genetic, psychological and environmental.
It is possible that children with hypochondriasis have learned from their families the tendency to focus anxiety on physical symptoms and illness.
In addition, they may have learned that people with illness have"certain advantages". It would be a learning experience developed in the family.
By having the role of sick, you would have the advantages of care, greater care or fewer responsibilities.
On the other hand, hypochondriasis is more likely to develop in the face of stressful life events.
Death or illness of close relatives may develop hypochondriasis. When approaching the relative's age, the person may believe that he is suffering from the same illness that caused the death of the person close to him.
Outbreaks of major diseases or pandemics can also contribute to hypochondria, as can statistics on diseases such as cancer.
Symptoms of hypochondriasis
People with hypochondriasis experience physical sensations that all have, but focus on.
That act of focusing on oneself increases the activation and causes the physical sensations to be of greater intensity.
In addition to this increase of intensity, to think that the sensations are symptoms of disease, they increase even more the intensity of the sensations.
His frequent symptoms are:
- To have anxiety Or long-term fear of having a physical illness.
- Worry about symptoms or bodily diseases.
- Go to doctors repeatedly or have regular medical tests.
- Talk continuously with friends or family about suspicious symptoms or illnesses.
- Conduct obsessive health research.
- Check the body frequently for signs, such as lumps or sores.
- Check vital signs frequently, such as pulse or blood pressure.
Diagnosis of Hypochondriasis
Diagnostic criteria according to DSM-IV
A) Concern and fear of having, or conviction to suffer, a serious illness from the personal interpretation of somatic symptoms.
B) The concern persists despite appropriate medical examinations and explanations.
C) The belief expressed in criterion A is not delusional (unlike somatic type delusional disorder) and is not limited to concerns about physical appearance (as opposed to body dysmorphic disorder).
D) Concern causes clinically significant discomfort or social, occupational, or other significant impairment of the individual's activity.
E) The duration of the disorder of at least 6 months.
F) The concern is not better explained by the presence of generalized anxiety disorder, Obsessive-compulsive disorder , Anxiety disorder, Major depressive episode , Separation anxiety Or other somatoform disorder.
Specify if:
With little awareness of illness: if for most of the episode the individual does not realize that the concern about suffering from a serious illness is excessive or unjustified.
Diagnosis according to ICE-10 (World Health Organization)
ICE-10 defines hypochondriasis as follows:
A. Any of the following:
- A persistent belief of at least six months duration of the presence of a maximum of two real physical diseases (of which at least one must be named specifically by the patient).
- A persistent concern about an alleged deformity or disfigurement (body dysmorphic disorder).
B. Concern for belief and symptoms that cause discomfort or interference with interpersonal functioning in daily life, and that guides the patient to seek medical treatment or research.
C. Persistent refusal to accept that there are no adequate physical causes for symptoms or physical abnormalities except for short periods of a few weeks after the medical diagnosis.
D. Most use exclusion criteria: they do not occur only during schizophrenia disorders and related disorders or another mood disorder.
Differential diagnosis
There are different people who have a fear of developing a disease than those who are worried about having it.
The person who is afraid to develop a disease can be diagnosed with a disease phobia and usually has a younger age of onset.
The person who is anxious about having an illness can be diagnosed with hypochondria. It usually has a higher age of onset and has higher anxiety rates and checking behaviors.
Another mental disorder resembling hypochondriasis is panic disorder. People with this disorder also misinterpret physical symptoms such as the onset of a panic attack.
However, these people fear that immediate catastrophic symptoms will appear after a few minutes of symptoms.
On the contrary, hypochondriac people pay attention to long-term symptoms and diseases. That is, they can focus on the emergence of diseases such as cancer, AIDS...
Another differential feature is that hypochondriac people continue to visit doctors, although they confirm that they have nothing. People with panic attacks stop going to doctors, but still believe that attacks can kill them.
However, not everyone who cares about health problems has hypochondria; Having symptoms whose causes can not be identified by a doctor can lead to anxiety.
It is not bad to know about the disorder or illness that is suffering. The problem comes when you think that something is going wrong even after several tests have been done and have gone to several doctors.
Treatment of hypochondriasis
The main treatments for hypochondriasis are Cognitive-behavioral therapy And sometimes medication.
Recent medical research has found that cognitive-behavioral therapy and selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine and paroxetine are effective options.
It is a difficult disorder to treat, because people who have it refuse to believe that their symptoms are not causing a real illness.
It is advisable that the course of the patient is followed by a reliable doctor with whom he can develop a good relationship.
This doctor can observe the symptoms and be alert for the possibility that any change can be a sign of a real physical illness.
Risk factor's
Factors that may increase the risk of developing hypochondriasis may include:
- Having a serious illness in childhood.
- Know family members or close people who have had or have serious illnesses.
- The death of a loved one.
- Having an anxiety disorder.
- Believing that good health means being free of symptoms or physical sensations.
- Having close relatives with hypochondria.
- Feeling especially vulnerable to illness.
- Having an overprotective family.
Complications
There may be several complications arising from this disorder:
- Medical risks associated with unnecessary medical procedures.
- Depression .
- Anxiety disorders .
- Frustration or hatred.
- Substance abuse.
- School problems.
- Difficulties in personal relationships.
- Economic problems due to the cost of tests and medical examinations.
References
- American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Revised text, Washington, DC, APA, 2000.
- Daniel L. Schacter, Daniel T. Gilbert, Daniel M. Wegner (2011). Generalized Anxiety Disorder. Psychology second edition.
- "Hypochondriasis."CareNotes. Thomson Healthcare, Inc., 2011. Health Reference Center Academic. Retrieved April 5, 2012.
- Barsky AJ, Ahern DK: Cognitive behavior therapy for hypochondriasis: a randomized controlled trial. Jama 2004; , 291: 1464-1470.
- Barsky AJ, Ahern DK: Cognitive behavior therapy for hypochondriasis: a randomized controlled trial. Jama 2004; , 291: 1464-1470.
- Clark DM, Salkovskis PM, Hackman A, Wells A, Fennell M, Ludgate J, Ahmand S, Richards HC, Gelder M: Two psychological treatments for hypochondriasis, a randomized controlled trial. Br J Psychiatry 1998; 173: 218-225.
- Fallon BA, Schneier FR, Marshall R, Campeas R, Vermes D, Goetz D, Liebowitz MR: The pharmacotherapy of hypochondriasis. Psychopharmacol Bull nineteen ninety six; 32: 607-611.
- Fallon BA, Qureshi AI, Schneiner FR, Sanchez-Lacay A, Vermes D, Feinstein R, Connelly J, Liebowitz MR: An open trial of fluvoxamine for hypochondriasis. Psychosomatics 2003; 44: 298-303.
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