Hypochondriacal concerns in a community population

Hypochondriasis is recognized as an important disorder in clinical populations, associated with increased health care utilization, disability and psychiatric co-morbidity. Few studies have investigated hypochondriasis in the community. We report on the broader concept of illness worry in a community population.

Five hundred and seventy-six subjects from an ethnically diverse urban setting were surveyed. Information was gathered on sociodemographic variables, medical and psychiatric status, health care utilization and disability. Bivariate and multivariate regression analyses were used to compare groups with illness worry (with and without the medical condition) to those without illness worry.

Only one subject of 533 (0.2%) met criteria for hypochondriasis and seven (1.3%) fulfilled abridged criteria. However, 33 (6%) of the sample had illness worry. Of these, 17 had the illness about which they worried. Compared with controls, both illness worry groups had elevated levels of medical illness, psychiatric symptoms, help-seeking, health care use and disability. In multiple regression analyses, illness worry was an independent predictor of somatic symptoms, help-seeking, and disability, when sociodemographic and medical variables were controlled.

Hypochondriasis appears to be a rare disorder in the community while illness worry is relatively common. Illness worry was present in equal numbers of subjects with the illness of concern, as those without. Illness worry was an independent factor contributing to increased levels of distress, health care utilization, and disability, even when medical status was controlled, suggesting that it is an important issue for further research.