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A study of so-called hypochondriasis.

C von Scheele1, L Nordgren, V Kempi

  • 1Department of Medicine, Ostersund Hospital, Sweden.

Psychotherapy and Psychosomatics
|January 1, 1990
PubMed
Summary
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Patients with unexplained physical symptoms were diagnosed with anxiety or somatization disorders. Biochemical tests showed correlations between monoamine metabolites and alexithymia, suggesting these may play a role in somatic symptom disorders.

Area of Science:

  • Psychiatry
  • Neuroscience
  • Clinical Medicine

Background:

  • Unexplained somatic complaints are common in clinical practice.
  • Accurate diagnosis and understanding of underlying mechanisms are crucial for effective treatment.

Purpose of the Study:

  • To investigate the psychiatric diagnoses and biochemical correlates of patients with unexplained somatic complaints.
  • To explore the relationship between alexithymia, monoamine metabolites, and somatic symptom disorders.

Main Methods:

  • Clinical appraisal using DSM-III criteria for 24 patients with negative somatic examinations.
  • Biochemical investigations including TRH load, dexamethasone suppression test, and CSF monoamine metabolites (5-HIAA, HVA).
  • Assessment of alexithymia and depression using validated scales.

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Main Results:

  • Generalized anxiety disorder (GAD) in 12, somatization disorder (SD) in 8, and hypochondriasis in 4 patients.
  • Significant correlations found between cerebrospinal fluid (CSF) homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) values, and alexithymia scores.
  • Biochemical markers and depression scales were inconsistent with a diagnosis of depressive illness.

Conclusions:

  • Patients with unexplained somatic complaints often have underlying anxiety or somatization disorders.
  • Alexithymia may be linked to specific monoamine metabolite levels in these patients.
  • A therapeutic relationship is vital for managing distrust and reducing healthcare utilization in hypochondriasis.