Reading About a Disease and Thinking You Have It

Medical condition

Hypochondriasis
Other names	Hypochondria, health anxiety (HA), illness feet disorder, somatic symptom disorder
Honoré Daumier, The Imaginary Disease (c.  1860—1862)
Specialty	Psychiatry, psychology
Symptoms	Excessive and persistent fear of, or preoccupation with, having or developing a severe disease
Usual onset	Any time from early babyhood
Differential diagnosis	Actual serious medical condition, panic disorder, obsessive-compulsive disorder, generalized anxiety disorder
Treatment	Cognitive behavioral therapy (CBT)
Medication	SSRI, antidepressants
Prognosis	~50% meet criteria afterward ~1-5 yrs
Frequency	~five%

Human in grief suffering from hypochondriasis

Hypochondriasis or hypochondria is a condition in which a person is excessively and unduly worried nearly having a serious illness. An former concept, the meaning of hypochondria has repeatedly changed.^[1] It has been claimed that this debilitating condition results from an inaccurate perception of the condition of torso or heed despite the absence of an bodily medical diagnosis.^[2] An individual with hypochondriasis is known as a hypochondriac. Hypochondriacs become disproportionately alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they have, or are well-nigh to exist diagnosed with, a serious disease.^[3]

Often, hypochondria persists even after a medico has evaluated a person and reassured them that their concerns well-nigh symptoms practise non have an underlying medical basis or, if there is a medical illness, their concerns are far in backlog of what is advisable for the level of disease. Information technology is as well referred to hypochondriaism which is the human activity of being in a hypochondriatic land, astute hypochondriaism.^[iv] Many hypochondriacs focus on a particular symptom as the catalyst of their worrying, such as gastro-intestinal issues, palpitations, or musculus fatigue. To qualify for the diagnosis of hypochondria the symptoms must have been experienced for at least 6 months.^[5]

International Classification of Diseases (ICD-x) classifies hypochondriasis as a mental and behavioral disorder. ^[half-dozen] In the Diagnostic and Statistical Manual of Mental Disorders, DSM-IV-TR defined the disorder, "Hypochondriasis", as a somatoform disorder^[seven] and one study has shown it to affect near 3% of the visitors to primary intendance settings.^[8] The 2013 DSM-five replaced the diagnosis of hypochondriasis with the diagnoses of somatic symptom disorder (75%) and illness anxiety disorder (25%).^{[9] [10]}

Hypochondria is often characterized by fears that minor bodily or mental symptoms may bespeak a serious illness, constant cocky-examination and self-diagnosis, and a preoccupation with one'southward body. Many individuals with hypochondriasis limited doubtfulness and disbelief in the doctors' diagnosis, and study that doctors' reassurance well-nigh an absence of a serious medical condition is unconvincing, or short-lasting. Additionally, many hypochondriacs feel elevated claret pressure, stress, and anxiety in the presence of doctors or while occupying a medical facility, a condition known as "white coat syndrome". Many hypochondriacs crave abiding reassurance, either from doctors, family unit, or friends, and the disorder can go a debilitating claiming for the private with hypochondriasis, as well as their family and friends.^[11] Some hypochondriacal individuals completely avoid whatever reminder of illness, whereas others oftentimes visit medical facilities, sometimes obsessively. Some sufferers may never speak about it.

Signs and symptoms [edit]

Hypochondriasis is categorized every bit a somatic distension disorder—a disorder of "perception and cognition"^[2]—that involves a hyper-vigilance of state of affairs of the trunk or mind and a trend to react to the initial perceptions in a negative mode that is further debilitating. Hypochondriasis manifests in many ways. Some people take numerous intrusive thoughts and concrete sensations that push them to check with family, friends, and physicians. For example, a person who has a minor coughing may think that they take tuberculosis.^[12] Or sounds produced past organs in the torso, such equally those made past the intestines, might be seen as a sign of a very serious illness to patients dealing with hypochondriasis.^[13]

Other people are so afraid of any reminder of illness that they will avoid medical professionals for a seemingly pocket-size problem, sometimes to the indicate of becoming neglectful of their health when a serious status may exist and go undiagnosed. Yet others live in despair and depression, certain that they accept a life-threatening illness and no doc can help them. Some consider the disease equally a punishment for past misdeeds.^[14]

Hypochondriasis is often accompanied by other psychological disorders. Bipolar disorder, clinical depression, obsessive-compulsive disorder (OCD), phobias, and somatization disorder are the most common accompanying conditions in people with hypochondriasis, equally well every bit a generalized anxiety disorder diagnosis at some signal in their life.^[15]

Many people with hypochondriasis experience a cycle of intrusive thoughts followed by compulsive checking, which is very similar to the symptoms of obsessive-compulsive disorder. However, while people with hypochondriasis are afraid of having an illness, patients with OCD worry about getting an illness or of transmitting an illness to others.^[14] Although some people might take both, these are distinct conditions.^[16]

Patients with hypochondriasis often are not aware that depression and feet produce their ain physical symptoms, and error these symptoms for manifestations of another mental or physical disorder or illness. For instance, people with low ofttimes experience changes in appetite and weight fluctuation, fatigue, decreased interest in sex, and motivation in life overall.^[17] Intense anxiety is associated with rapid heartbeat, palpitations, sweating, musculus tension, stomach discomfort, dizziness, shortness of jiff, and numbness or tingling in sure parts of the body (hands, forehead, etc.).^[18]

If a person is ill with a medical disease such equally diabetes or arthritis, there volition often exist psychological consequences, such every bit depression. Some fifty-fifty report being suicidal.^[19] In the same fashion, someone with psychological issues such every bit depression or anxiety will sometimes experience physical manifestations of these melancholia fluctuations, often in the form of medically unexplained symptoms.^[twenty] Common symptoms include headaches; intestinal, back, joint, rectal, or urinary hurting; nausea; fever and/or night sweats; itching; diarrhea; dizziness; or balance problems. Many people with hypochondriasis accompanied by medically unexplained symptoms experience they are not understood past their physicians, and are frustrated by their doctors' repeated failure to provide symptom relief.^[21]

Cause [edit]

The genetic contribution to hypochondriasis is probably moderate, with heritability estimates effectually ten-37%. Not-shared ecology factors (i.e., experiences that differ between twins in the aforementioned family) explain virtually of the variance in fundamental components of the condition such as the fear of disease and affliction conviction. In contrast, the contribution of shared environmental factors (i.east., experiences shared by twins in the same family) to hypochondriasis is approximately zero.^[22]

Although little is known nearly exactly which non-shared environmental factors typically contribute to causing hypochondriasis, certain factors such as exposure to affliction-related information are widely believed to atomic number 82 to brusque-term increases in health anxiety and to accept contributed to hypochondriasis in individual cases. Overly protective caregivers and an excessive focus on small health concerns take besides been implicated every bit potential causes of hypochondriasis.^[23]

In the media and on the Internet, articles, Television receiver shows, and advertisements regarding serious illnesses such as cancer and multiple sclerosis often portray these diseases as being random, obscure, and somewhat inevitable. In the short term, inaccurate portrayal of gamble and the identification of not-specific symptoms as signs of serious illness may contribute to exacerbating fear of illness. Major affliction outbreaks or predicted pandemics tin take like effects.

At that place is anecdotal prove that it is common for serious illnesses or deaths of family members or friends to trigger hypochondria in certain individuals. Similarly, when approaching the age of a parent's premature decease from disease, many otherwise healthy, happy individuals fall prey to hypochondria. These individuals believe they are suffering from the same disease that caused their parent's expiry, sometimes causing panic attacks with corresponding symptoms.^[24]

Diagnosis [edit]

The ICD-10 defines hypochondriasis equally follows:

A. Either one of the following:

• A persistent belief, of at least six months' duration, of the presence of a minimum of ii serious concrete diseases (of which at to the lowest degree one must be specifically named by the patient).
• A persistent preoccupation with a presumed deformity or disfigurement (body dysmorphic disorder).

B. Preoccupation with the conventionalities and the symptoms causes persistent distress or interference with personal functioning in daily living and leads the patient to seek medical treatment or investigations (or equivalent aid from local healers).

C. Persistent refusal to have medical advice that there is no adequate physical crusade for the symptoms or physical abnormality, except for short periods of up to a few weeks at a time immediately afterward or during medical investigations.

D. Near commonly used exclusion criteria: not occurring merely during any of the schizophrenia and related disorders (F20–F29, particularly F22) or any of the mood disorders (F30–F39).

The DSM-IV defines hypochondriasis co-ordinate to the following criteria:^[seven]

A. Preoccupation with fears of having, or the idea that one has, a serious illness based on the person's misinterpretation of bodily symptoms.
B. The preoccupation persists despite appropriate medical evaluation and reassurance.
C. The belief in Criterion A is not of delusional intensity (equally in Delusional Disorder, Somatic Type) and is not restricted to a circumscribed concern nigh appearance (as in Body Dysmorphic Disorder).
D. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Eastward. The duration of the disturbance is at least half dozen months.
F. The preoccupation is not better accounted for by Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, a Major Depressive Episode, Separation Anxiety, or some other Somatoform Disorder.

In the 5th version of the DSM (DSM-5), most who met criteria for DSM-IV hypochondriasis instead meet criteria for a diagnosis of somatic symptom disorder (SSD) or affliction anxiety disorder (IAD).^[9]

Classification [edit]

The nomenclature of hypochondriasis in relation to other psychiatric disorders has long been a topic of scholarly contend and has differed widely between different diagnostic systems and influential publications.

In the instance of the DSM, the first and second versions listed hypochondriasis as a neurosis, whereas the tertiary and fourth versions listed hypochondriasis as a somatoform disorder. The current version of the DSM (DSM-5) lists somatic symptom disorder (SSD) nether the heading of "somatic symptom and related disorders", and illness anxiety disorder (IAD) under both this heading and as an anxiety disorder.

The ICD-10, like the third and fourth versions of the DSM, lists hypochondriasis as a somatoform disorder. The ICD-11, however, lists hypochondriasis nether the heading of "obsessive-compulsive or related disorders".

At that place are also numerous influential scientific publications that have argued for other classifications of hypochondriasis. Notably, since the early 1990s, information technology has get increasingly mutual to regard hypochondriasis every bit an anxiety disorder, and to refer to the status as "wellness anxiety" or "severe health anxiety".

Handling [edit]

Approximately 20 randomized controlled trials and numerous observational studies betoken that cognitive behavioral therapy (CBT) is an effective treatment for hypochondriasis.^{[25] [26] [27] [28]} Typically, most two-thirds of patients respond to treatment, and about fifty% of patients accomplish remission, i.e., no longer suffer from hypochondriasis later treatment.^[28] CBT for hypochondriasis and health feet may be offered in diverse formats, including as face up-to-face up individual or group therapy, via telephone,^[29] or as guided self-help with information conveyed via a cocky-help volume^[30] or online treatment platform.^[31] Effects are typically sustained over time.^{[32] [28]}

At that place is as well evidence that antidepressant medications such equally selective serotonin reuptake inhibitors can reduce symptoms.^{[33] [34]} In some cases, hypochondriasis responds well to antipsychotics, particularly the newer singular antipsychotic medications.^[35]

Etymology [edit]

Amongst the regions of the abdomen, the hypochondrium is the uppermost part. The word derives from the Greek term ὑποχόνδριος hypokhondrios, meaning "of the soft parts betwixt the ribs and umbilicus" from ὑπό hypo ("under") and χόνδρος khondros, or cartilage (of the sternum). Hypochondria in Late Latin meant "the belly".^[36]

The term hypochondriasis for a state of disease without real crusade reflected the ancient belief that the viscera of the hypochondria were the seat of melancholy and sources of the vapor that caused morbid feelings.^{[37] [ self-published source? ]} Until the early 18th century, the term referred to a "physical disease caused by imbalances in the region that was below your rib muzzle" (i.e., of the stomach or digestive arrangement). For example, Robert Burton'due south The Anatomy of Melancholy (1621) blamed information technology "for everything from 'as well much spittle' to 'rumbling in the guts'".^[38]

Immanuel Kant discussed hypochondria in his 1798 volume, Anthropology from a Pragmatic Point of View, like this:

The illness of the hypochondriac consists in this: that certain bodily sensations do not so much bespeak a really existing disease in the body as rather merely excite apprehensions of its existence: and homo nature is so constituted – a trait which the animal lacks – that information technology is able to strengthen or make permanent local impressions simply past paying attention to them, whereas an abstraction – whether produced on purpose or by other diverting occupations – lessens these impressions, or even effaces them altogether.

• Anthropology by Immanuel Kant, 1798 Periodical of Speculative Philosophy Vol. Sixteen edited past William Torrey Harris p. 395-396

Run across likewise [edit]

• Nosophobia
• Cyberchondria
• Mithridatism
• Munchausen syndrome
• Nocebo
• Psychosomatic medicine
• Sickness behavior
• Somatoform disorder
• Somatosensory distension
• Man influenza
• The Imaginary Invalid

References [edit]

1. ^ Berrios GE (2001) Hypochondriasis. History of the Concept. In Starcevic V & Lipsitt DR (eds). Hypochondriasis. Oxford, Oxford Academy Printing, pp3-20.
2. ^ ^{a b} Avia Doc, Ruiz MA (2005). "Recommendations for the Handling of Hypochondriac Patients". Periodical of Contemporary Psychotherapy. 35 (3): 301–xiii. doi:ten.1007/s10879-005-4322-three. S2CID 28529570.
3. ^ Kring AM, Davison GC, Neale JM, Johnson SL (2007). Abnormal Psychology with Cases (10th ed.). Wiley. ISBN978-0-471-71260-2. ^{[ folio needed ]}
4. ^ Shan-Tilly
5. ^ Goldberg RJ (2007). Practical Guide to the Intendance of the Psychiatric Patient. ISBN978-0-323-03683-2. ^{[ page needed ]}
6. ^ Drs; Sartorius, Norman; Henderson, A.S.; Strotzka, H.; Lipowski, Z.; Yu-cun, Shen; You-xin, Xu; Strömgren, Due east.; Glatzel, J.; Kühne, Yard.-Due east.; Misès, R.; Soldatos, C.R.; Pull, C.B.; Giel, R.; Jegede, R.; Malt, U.; Nadzharov, R.A.; Smulevitch, A.B.; Hagberg, B.; Perris, C.; Scharfetter, C.; Clare, A.; Cooper, J.Due east.; Corbett, J.A.; Griffith Edwards, J.; Gelder, M.; Goldberg, D.; Gossop, Chiliad.; Graham, P.; Kendell, R.Eastward.; Marks, I.; Russell, M.; Rutter, Grand.; Shepherd, 1000.; West, D.J.; Wing, J.; Wing, L.; Neki, J.Due south.; Benson, F.; Cantwell, D.; Guze, S.; Helzer, J.; Holzman, P.; Kleinman, A.; Kupfer, D.J.; Mezzich, J.; Spitzer, R.; Lokar, J. "The ICD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines" (PDF). www.who.int World Wellness Organization. Microsoft Word. bluebook.doc. p. 116. Retrieved 23 June 2021 – via Microsoft Bing. {{cite spider web}}: CS1 maint: url-status (link)
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9. ^ ^{a b} "DSM-v redefines hypochondriasis - Mayo Clinic". Mayo Dispensary.
10. ^ Diagnostic and statistical manual of mental disorders : DSM-v (5th ed.). American Psychiatric Clan. 2013. p. 310. ISBN9780890425541.
11. ^ Olatunji BO, Etzel EN, Tomarken AJ, Ciesielski BG, Deacon B (November 2011). "The effects of safety behaviors on health anxiety: an experimental investigation". Behaviour Research and Therapy. 49 (xi): 719–28. doi:x.1016/j.brat.2011.07.008. PMID 21839987.
12. ^ Schacter DL, Gilbert DT, Wegner DM (2011). "Generalized Anxiety Disorder". Psychology (second ed.). ISBN9781429237192.
13. ^ "Illness Anxiety Disorder". National Eye for Biotechnology Information, U.S. National Library of Medicine . Retrieved 2021-06-24 .
14. ^ ^{a b} Fallon BA, Qureshi AI, Laje G, Klein B (September 2000). "Hypochondriasis and its relationship to obsessive-compulsive disorder". The Psychiatric Clinics of North America. 23 (3): 605–16. doi:10.1016/S0193-953X(05)70183-0. PMID 10986730.
15. ^ Barsky AJ (Dec 1992). "Hypochondriasis and obsessive compulsive disorder". The Psychiatric Clinics of North America. 15 (four): 791–801. doi:10.1016/S0193-953X(18)30209-0. PMID 1461796.
16. ^ Fallon, B. A.; Qureshi, A. I.; Laje, Grand.; Klein, B. (September 2000). "Hypochondriasis and its relationship to obsessive-compulsive disorder". The Psychiatric Clinics of North America. 23 (3): 605–616. doi:ten.1016/s0193-953x(05)70183-0. ISSN 0193-953X. PMID 10986730.
17. ^ "NIMH » Depression Basics". www.nimh.nih.gov . Retrieved 2019-11-20 .
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19. ^ "Mental Health | ADA". www.diabetes.org . Retrieved 2019-x-x .
20. ^ Gelenberg AJ (Apr 2000). "Psychiatric and Somatic Markers of Feet: Identification and Pharmacologic Treatment". Primary Intendance Companion to the Journal of Clinical Psychiatry. 2 (two): 49–54. doi:10.4088/pcc.v02n0204. PMC181205. PMID 15014583.
21. ^ "Illness Anxiety Disorder". The Lecturio Medical Concept Library . Retrieved 2021-06-24 .
22. ^ Taylor S, Thordarson DS, Jang KL, Asmundson GJ (2006). "Genetic and ecology origins of health anxiety: a twin written report". World Psychiatry. 5 (1): 47–fifty. PMC1472263. PMID 16757996.
23. ^ "Hypochondriasis." CareNotes. Thomson Healthcare, Inc., 2011. Health Reference Middle Academic. Retrieved April 5, 2012.^{[ verification needed ]}
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25. ^ Olatunji BO, Kauffman Past, Meltzer S, Davis ML, Smits JA, Powers MB (July 2014). "Cognitive-behavioral therapy for hypochondriasis/health anxiety: a meta-analysis of handling outcome and moderators". Behaviour Research and Therapy. 58: 65–74. doi:ten.1016/j.brat.2014.05.002. PMID 24954212.
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27. ^ Cooper, Kate; Gregory, James D.; Walker, Ian; Lambe, Sinead; Salkovskis, Paul One thousand. (March 2017). "Cognitive Behaviour Therapy for Health Feet: A Systematic Review and Meta-Analysis". Behavioural and Cognitive Psychotherapy. 45 (ii): 110–123. doi:10.1017/S1352465816000527. ISSN 1352-4658. PMID 28229805.
28. ^ ^{a b c} Axelsson, Erland; Hedman-Lagerlöf, Erik (2019-11-02). "Cognitive behavior therapy for health anxiety: systematic review and meta-assay of clinical efficacy and health economic outcomes". Expert Review of Pharmacoeconomics & Outcomes Research. 19 (half dozen): 663–676. doi:10.1080/14737167.2019.1703182. ISSN 1473-7167. PMID 31859542.
29. ^ Morriss, Richard; Patel, Shireen; Malins, Sam; Guo, Boliang; Higton, Fred; James, Marilyn; Wu, Mengjun; Brown, Paula; Boycott, Naomi; Kaylor-Hughes, Catherine; Morris, Martin (Dec 2019). "Clinical and economical outcomes of remotely delivered cognitive behaviour therapy versus treatment as usual for echo unscheduled care users with severe health anxiety: a multicentre randomised controlled trial". BMC Medicine. 17 (1): xvi. doi:10.1186/s12916-019-1253-v. ISSN 1741-7015. PMC6343350. PMID 30670044.
30. ^ Axelsson, Erland; Andersson, Erik; Ljótsson, Brjánn; Hedman-Lagerlöf, Erik (August 2018). "Toll-effectiveness and long-term follow-up of three forms of minimal-contact cognitive behaviour therapy for severe health anxiety: Results from a randomised controlled trial". Behaviour Enquiry and Therapy. 107: 95–105. doi:10.1016/j.deviling.2018.06.002. hdl:10616/46521. PMID 29936239. S2CID 49406483.
31. ^ Axelsson, Erland; Andersson, Erik; Ljótsson, Brjánn; Björkander, Daniel; Hedman-Lagerlöf, Maria; Hedman-Lagerlöf, Erik (2020). "Effect of Internet vs Face up-to-Face Cognitive Behavior Therapy for Health Anxiety: A Randomized Noninferiority Clinical Trial". JAMA Psychiatry. 77 (ix): 915–924. doi:ten.1001/jamapsychiatry.2020.0940. PMC7221860. PMID 32401286.
32. ^ Tyrer, P.; Wang, D.; Crawford, G.; Dupont, South.; Cooper, Southward.; Nourmand, S.; Lazarevic, V.; Philip, A.; Tyrer, H. (2020-03-xvi). "Sustained benefit of cognitive behaviour therapy for health anxiety in medical patients (Gnaw) over 8 years: a randomised-controlled trial". Psychological Medicine. 51 (10): 1714–1722. doi:10.1017/S003329172000046X. ISSN 0033-2917. PMID 32174296. S2CID 212731146.
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34. ^ Fallon, Brian A.; Ahern, David Grand.; Pavlicova, Martina; Slavov, Iordan; Skritskya, Natalia; Barsky, Arthur J. (August 2017). "A Randomized Controlled Trial of Medication and Cerebral-Behavioral Therapy for Hypochondriasis". American Journal of Psychiatry. 174 (8): 756–764. doi:10.1176/appi.ajp.2017.16020189. ISSN 0002-953X. PMC5957509. PMID 28659038.
35. ^ Harth W, Gieler U, Kusnir D, Tausk FA (2008). "Hypochondriacal Delusions". Clinical Management in Psychodermatology. Springer. p. 36. ISBN978-3-540-34718-vii.
36. ^ "hypochondria (n.)". Etymonline . Retrieved fourteen Apr 2015.
37. ^ Harvey South (Feb 21, 2010). "Hypochondria". The Virtual Linguist. ^{[ self-published source ]}
38. ^ Mann L (July 11, 2012). "New volume tries to explain the roots of hypochondria". Chicago Tribune.

Further reading [edit]

• Belling C (2012). A Condition of Incertitude: The Meanings of Hypochondria. New York: Oxford University Printing. ISBN978-0199892365.

External links [edit]

• Hypochondriasis at Curlie

This audio file was created from a revision of this article dated eighteen December 2006 (2006-12-eighteen), and does not reverberate subsequent edits.

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Source: https://en.wikipedia.org/wiki/Hypochondriasis

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