In hypochondriasis, people are preoccupied with the fear of having a serious disease or are preoccupied with the belief that they actually have a disease. These feelings are usually based on a misinterpretation of normal bodily sensations or minor physical symptoms.
Hypochondriasis begins most commonly during early adulthood and appears to affect both sexes equally.
People misinterpret normal bodily functions or minor physical symptoms that are not related to any abnormality or disorder. These symptoms may include abdominal bloating, rumbling in the abdomen, awareness of the heartbeat, sweating, pain, and fatigue. People may describe their symptoms in minute detail. They think that the symptoms indicate a serious physical disorder. For example, they may think headaches indicate a brain tumor. The symptoms cause them great distress. As people become increasingly concerned with health issues, personal relationships and work performance often suffer.
Examination and reassurance by a doctor do not relieve the concerns of people with hypochondriasis. They tend to believe that the doctor has somehow failed to find the underlying disorder.
Some people with hypochondriasis also have depression or anxiety.
Hypochondriasis often persists, lasting years. In some people, it comes and goes. Some people recover completely.
Hypochondriasis is suspected when healthy people with minor symptoms are preoccupied with the significance of the symptoms and do not respond to reassurance after a thorough medical evaluation.
The diagnosis of hypochondriasis is confirmed if the situation persists for at least 6 months despite a medical evaluation and a doctor's reassurance and if the symptoms cannot be attributed to depression or another mental health disorder.
Treatment can be difficult because people with hypochondriasis believe that something inside the body is seriously wrong. Reassurance does not relieve these concerns. However, a supportive, trustful relationship with a caring doctor is beneficial, especially if regular visits are scheduled. If symptoms are not adequately relieved, people may benefit from referral to a psychiatrist or another mental health practitioner for further evaluation and treatment, with continuing care by the primary doctor.
Treatment with serotonin reuptake inhibitors, a class of antidepressants, may be effective. Cognitive-behavioral therapy may also relieve symptoms.
Last full review/revision June 2008 by Katharine A. Phillips, MD