Hypochondriasis. Medical management and psychiatric treatment

This study describes a 2-part approach to the hypochondriacal patient: 1) a strategy for medical management, and 2) a specific psychiatric therapy. Medical management rests on the physician's recognition that patients have psychological and interpersonal reasons for feeling symptomatic and seeking medical attention. After gaining this appreciation, the physician can stop trying to cure the patient's symptoms, and the goal of management then shifts to assisting the patient in coping with the symptoms. A specific psychotherapy is then presented. Group discussions and cognitive and behavioral exercises are used to teach patients to moderate four factors that amplify somatic distress and hypochondriacal health concerns: the attention they pay to their symptoms, their thoughts about them, the context in which they experience their symptoms, and their moods.