Hypochondria

Alternative names 
Hypochondriasis

Definition
Hypochondria is a belief that real or imagined physical symptoms are signs of a serious illness, despite medical reassurance and other evidence to the contrary.

Causes, incidence, and risk factors

A person suffering from hypochondria is preoccupied with physical health and has an unrealistic fear of serious disease well out of proportion to the actual risk. There is no specific cause of hypochondria, and it occurs in men and women with equal frequency.

Symptoms

     
  • preoccupation with fear of illness  
  • persistent fear of having a serious illness despite medical reassurance  
  • misinterpretation of symptoms  
  • symptoms that may shift and change  
  • symptoms that may be vague or specific (see somatoform pain disorder)  
  • no apparent physical disorder that can account for symptoms  
  • disturbance lasting for at least 6 months (24 weeks)

The affected person may recognize that the fear of having a serious disease may be excessive, unreasonable, or unfounded.

Signs and tests

A physical examination should be performed to rule out an underlying organic disease. A psychological evaluation should be performed to rule out other related disorders.

Treatment

A supportive relationship with a health care provider is the mainstay of treatment. There should be one primary provider to avoid unnecessary diagnostic tests and procedures.

The health care provider should inform the person that no organic disease is present, but that continued medical follow-up will help control the symptoms. The person with hypochondria feels real distress, so the symptoms should not be denied or challenged by others.

Expectations (prognosis)

Generally, the disorder is chronic (lasts for a long time) unless the psychological factors or any related underlying mood disorder are addressed.

Complications

     
  • There is a possibility that a real disease may be overlooked in people with hypochondria because their previous complaints were unfounded.  
  • Complications may result from invasive testing and multiple evaluations looking for the cause of symptoms.  
  • Dependence on pain relievers or sedatives may develop.  
  • Frequent appointments with health care providers are typical, and time from work may be lost.

Calling your health care provider

Call your health care provider if you or your child has symptoms of hypochondria.

Johns Hopkins patient information

Last revised: December 4, 2012
by Janet G. Derge, M.D.

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