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The validity of DSM-III-R hypochondriasis
R Noyes1, R G Kathol, M M Fisher
1Department of Psychiatry, University of Iowa, College of Medicine, Iowa City.
Archives of General Psychiatry
|December 1, 1993
Summary
Physicians can recognize hypochondriasis, a disorder often underdiagnosed. Validating this diagnosis can help reduce patient suffering and healthcare costs.
Area of Science:
- Psychiatry
- Internal Medicine
- Clinical Psychology
Background:
- Hypochondriasis diagnosis is uncertain and rarely made.
- This study examines the validity of DSM-III-R hypochondriasis criteria.
Purpose of the Study:
- To validate the DSM-III-R criteria for hypochondriasis.
- To assess the recognition and impact of hypochondriasis in a general medical setting.
Main Methods:
- Screened general medicine patients for hypochondriacal symptoms.
- Conducted structured diagnostic interviews for 50 hypochondriasis patients and 50 controls.
- Collected data on health perceptions, healthcare utilization, and functioning.
Main Results:
- Hypochondriacal subjects perceived their health as worse and had more health worries.
- Physicians rated hypochondriacal subjects higher on unrealistic fear of illness.
- Hypochondriacal patients showed poorer functioning, higher healthcare use, and less treatment satisfaction.
Conclusions:
- Physician recognition of hypochondriasis is high despite infrequent diagnosis.
- Evidence supports the internal and external validity of the hypochondriasis diagnostic category.
- Accurate diagnosis and intervention are needed to reduce patient impairment and healthcare costs.