Hypochondria (hy-po-KON-dree-a) is a mental disorder in which people believe or fear that they have a serious disease even though medical examination or tests show no sign of illness.
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More Than a Temporary Worry
Everyone has probably worried about their health from time to time. For example, a symptom such as chest pain can have many causes and is usually not serious. But if anyone experiencing this symptom has just read a newspaper article about someone who has had a heart attack * , they might worry that they are about to have one too. This temporary concern is not an example of hypochondria. With true hypochondria the worry is more lasting, and it interferes with one's daily life.
The prevalence of hypochondria among the general public is unknown, but studies have indicated that it accounts for between 4 and 9 percent of visits to doctors. Hypochondria occurs in all age groups and cultures and is about equally prevalent among males and females.
When Medical Reassurance Does Not Help
People with hypochondria may be overly concerned with a variety of symptoms and even with their normal bodily functions. Minor aches and pains, occasional coughing, dizziness, nausea, or small sores can convince people with hypochondria that they are seriously ill. They may also closely monitor normal bodily functions, such as heartbeat, breathing, sweating, and intestinal function, for signs of disease. The health worries of someone with hypochondria may be focused on a particular body organ, such as the heart, or on several parts of the body.
* heart attack is an injury to the heart muscle that occurs when blood flow is interrupted, cutting off the supply of oxygen to the heart.
An important characteristic of people with hypochondria is that they are not fully reassured after a medical examination and tests have shown no physical basis for their complaints. Although their fears may be temporarily relieved, the belief that they are ill may still be so strong that they go from one physician to another seeking new tests and treatments.
What Causes Hypochondria?
Why is it that some people are constantly worried about being sick? The cause or causes of hypochondria are not clearly understood, and experts have varying views.
One theory is that people who have hypochondria are excessively sensitive to their bodily sensations and may misinterpret their meaning. In some cases, hypochondria appears to be triggered by the death of a loved one. Researchers have also noted that hypochondria seems to be more common in people who were seriously ill as a child or who have spent a lot of time around sick relatives. Such past experiences may contribute to health worries.
Hypochondria may be one symptom of another mental disorder, such as depression * or anxiety * . For example, in some cases of obsessive-compulsive disorder * , a person may have extreme unfounded health worries and feel compelled to keep seeking reassurance from health professionals.
How Is Hypochondria Diagnosed and Treated?
The first step in diagnosing hypochondria is a thorough physical examination to make sure there is no medical disease or condition causing the patient's complaints. When the patient has been reassured that he or she is not ill, yet the intense health worries continue, the diagnosis of hypochondria may be made. The physician will need to take care not to confuse hypochondria with malingering * , or with such closely related mental conditions as conversion disorder * and Munchausen syndrome * .
* depression (de-PRESH-un) is a mental state characterized by feelings of sadness, despair, and discouragement.
* anxiety can be experienced as a troubled feeling, a sense of dread, fear of the future, or distress over a possible threat to a person's physical or mental well-being.
* obsessive-compulsive disorder causes people to feel trapped by distressing thoughts or to feel as if they have to repeat actions, such as washing hands.
* rmalingering (ma-LING-er-ing) means intentionally pretending to be sick or injured to avoid work or responsibility.
* conversion disorder is a mental disorder in which psychological symptoms are converted to physical symptoms, such as blindness, paralysis, or seizures. A person with conversion disorder does not intentionally produce symptoms.
* Munchausen syndrome (MOON-chow-zen SIN-drome)is a mental disorder in which a person pretends to have symptoms or causes symptoms of a disease in order to be hospitalized or receive tests, medication, or surgery.
Hypochondria can be difficult to treat because the beliefs about illness are usually very strong. Although reassurance that the person is in good health is necessary, it is likely to be helpful only for a short time. Psychotherapy can help a person to make gradual changes in the way they think about their bodily sensations and to cope with health anxiety. When hypochondria is a symptom of depression, anxiety, or obsessive-compulsive disorder, treatment focuses on the underlying disorder.