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Psychiatric comorbidity among patients with hypochondriasis
R Noyes1, R G Kathol, M M Fisher
1Department of Psychiatry, University of Iowa, College of Medicine, Iowa City.
General Hospital Psychiatry
|March 1, 1994
Summary
Hypochondriasis frequently co-occurs with other mental health conditions like depression and anxiety disorders in medical patients. This comorbidity may suggest hypochondriasis can lead to or be associated with these other illnesses.
Area of Science:
- Psychiatry
- Internal Medicine
- Clinical Psychology
Background:
- Hypochondriasis (now illness anxiety disorder) is a condition characterized by excessive worry about having a serious illness.
- Understanding its comorbidity is crucial for accurate diagnosis and effective treatment in general medical settings.
Purpose of the Study:
- To investigate the frequency and types of co-occurring psychiatric disorders (comorbidity) in patients with hypochondriasis.
- To explore the relationship between hypochondriasis and these comorbid conditions.
Main Methods:
- Patients in a general medicine clinic were screened for hypochondriacal attitudes and somatic symptoms.
- Eligible patients and matched controls underwent structured diagnostic interviews to assess for psychiatric disorders based on DSM-III-R criteria.
Main Results:
- 62% of hypochondriasis patients had lifetime comorbidity, compared to 30% of controls.
- Major depression and panic disorder with agoraphobia were the most common comorbid conditions.
- Depression often developed after hypochondriasis, while anxiety disorders frequently began concurrently or earlier.
Conclusions:
- Mood and anxiety disorders commonly coexist with hypochondriasis in medical outpatients.
- The relationship between hypochondriasis and comorbid conditions is complex, potentially involving symptom overlap, treatment bias, or causal links, particularly with depression.
- Hypochondriasis may sometimes be a feature of another underlying psychiatric illness.