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Encyclopedia > Hypochondria

Hypochondria (or hypochondriasis, sometimes referred to as health anxiety/health phobia) refers to an excessive preoccupation or worry about having a serious illness. Often, hypochondria persists even after a physician has evaluated a person and reassured him/her that his/her concerns about symptoms do not have an underlying medical basis or, if there is a medical illness, the concerns are far in excess of what is appropriate for the level of disease. Many people suffering from this disorder focus on a particular symptom as the catalyst of their worrying, such as gastro-intestinal problems, palpitations, or muscle fatigue. The DSM-IV-TR defines this disorder, “Hypochondriasis,” as a somatoform disorder and it is thought to plague about 1-5% of the general population.[1] Hypochondria is often characterized by fears that minor bodily symptoms may indicate a serious illness, constant self-examination and self-diagnosis, and a preoccupation with one's body. Many individuals with hypochondriasis express doubt and disbelief in the doctors' diagnosis, and report that doctors’ reassurance about an absence of a serious medical condition is unconvincing, or un-lasting. Many hypochondriacs require constant reassurance, either from doctors, family, or friends, and the disorder can become a disabling torment for the individual with hypochondriasis, as well as his or her family and friends. Some hypochondriacal individuals are completely avoidant of any reminder of illness, whereas others are frequent visitors of doctors’ offices. Other hypochondriacs will never speak about their terror, convinced that their fear of having a serious illness will not be taken seriously by those in whom they confide. Image File history File links Broom_icon. ... Human heart and lungs, from an older edition of Grays Anatomy. ... The hypochondrium is the upper part of the abdomen under the lowest ribs of the thorax. ... This article does not cite any references or sources. ... Self diagnosis is the process of diagnosing medical conditions in oneself. ... In general, diagnosis (plural diagnoses) has two distinct dictionary definitions. ...

Contents

Etymology and colloquial use

The term hypochondria comes from the Greek hypo- (below) and chondros (cartilage - of the breast bone), and is thought to have been originally coined by Hippocrates. It was thought by many Greek physicians of antiquity that many ailments were caused by the movement of the spleen, an organ located near the hypochondrium (the upper region of the abdomen just below the ribs on either side of the epigastrium). Later use in the 19th Century employed the term to mean, “illness without a specific cause,” and it is thought that around that time period the term evolved to be the male counterpart to female hysteria. In modern usage, the term hypochondriac is often used as a pejorative label for individuals who hold the belief that they have a serious illness despite repeated reassurance from physicians that they are perfectly healthy. The spleen is an organ located in the abdomen, where it functions in the destruction of old red blood cells and holding a reservoir of blood. ... The hypochondrium is the upper part of the abdomen under the lowest ribs of the thorax. ... The epigastrium is the upper central region of the abdomen. ... Hysteria is a diagnostic label applied to a state of mind, one of unmanageable fear or emotional excesses. ...


Manifestation and comorbidity

Hypochondriasis manifests in various ways. Some people have numerous intrusive thoughts and physical sensations that push them to check with family, friends and physicians. Other people are so afraid of any reminder of illness that they will avoid medical professionals for a seemingly minor problem, sometimes to the point of becoming neglectful of their health when a serious condition may exist and go undiagnosed. Yet, some others live in despair and depression, certain that they have a life-threatening disease and no physician can help them, considering the disease as a punishment for past misdeeds. [2]


Hypochondriasis is often accompanied by other psychological disorders. Clinical depression, obsessive-compulsive disorder (also known as OCD), phobias and somatization disorder are the most common accompanying conditions in people with hypochondriasis, as well as a generalized anxiety disorder diagnosis at some point in their life. [3] On the Threshold of Eternity. ... The term phobia, which comes from the Ancient Greek word for fear (φόβος, fobos), denotes a number of psychological and physiological conditions that can range from serious disabilities to common fears to minor quirks. ... Somatization disorder (or Briquets disorder) is a type of mental illness in which a patient manifests a psychiatric condition as a physical complaint. ... Generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by excessive, uncontrollable and often irrational worry about everyday things, which is disproportionate to the actual source of worry. ...


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. [2] Although some people might have both, these are distinct conditions.


Patients with hypochondriasis often are not aware that depression and anxiety produce their own physical symptoms that might be mistaken for signs of a serious medical disease. For example, people with depression often experience changes in appetite and weight fluctuation, fatigue, decreased interest in sex and motivation in life overall. Intense anxiety is associated with rapid heart beat, palpitations, sweating, muscle tension, stomach discomfort, and numbness or tingling in certain parts of the body (hands, forehead, etc.).


Factors contributing to hypochondria

Cyberchondria is a colloquial term for hypochondria in individuals who have researched medical conditions on the internet. The media and the internet often contribute to hypochondria, as articles, TV shows and advertisements regarding serious illnesses such as cancer and multiple sclerosis (some of the common diseases hypochondriacs think they have) often portray these diseases as being random, obscure and somewhat inevitable. Inaccurate portrayal of risk and the identification of non-specific symptoms as signs of serious illness contribute to exacerbating the hypochondriac’s fear that they actually have that illness. Cyberchondria is a colloquial term for hypochondria in individuals who have researched medical conditions on the internet. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ...


Major disease outbreaks or predicted pandemics can also contribute to hypochondria. Statistics regarding certain illnesses, such as cancer, will give hypochondriacs the illusion that they are more likely to develop the disease. A simple suggestion of mental illness can often trigger one with hypochondria to obsess over the possibility. This article is about outbreaks of disease. ...


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 death 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 death, sometimes causing panic attacks with corresponding symptoms.


A majority of people who experience physical pains or anxieties over non-existent ailments are not actually "faking it", but rather, experience the natural results of other emotional issues, such as very high amounts of stress. In medical terms, stress is the disruption of homeostasis through physical or psychological stimuli. ...

Grief that finds no vent in tears makes other organs weep

—Dr. Henry Maudsley, British psychiatrist

Our emotions have cognitive, physiological and feeling components. For example, when one is sad, an individual may simultaneously experience muscle weakness and loss of energy. Whether it is an emotional memory, a vivid fantasy, or a present situation, the brain treats it the same. It is a real experience processed through neural paths.


Family studies of hypochondriasis do not show a genetic transmission of the disorder. Among relatives of people suffering from hypochondriasis only somatization disorder and generalized anxiety disorder were more common than in average families. [2] Other studies have shown that the first degree relatives of patients with OCD have a higher than expected frequency of a somatoform disorder (either hypochondriasis or body dysmorphic disorder). [4] Many people with hypochondriasis point out a pattern of paying close attention to bodily sensations, preventative investigations, and checking with physicians, that they have learned from family members, but there is no definitive scientific support for this notion. Body dysmorphic disorder (BDD) is a mental disorder that involves a distorted body image. ...


Many people are aware that anxiety and depression are mediated by problems with brain chemicals such as serotonin and norepinephrine. The physical symptoms that people with anxiety or depression feel are indeed real bodily symptoms, and are in fact triggered by neurochemical changes. For example, too much norepinephrine will result in severe panic attacks with symptoms of increased heart rate and sweating, shortness of breath, and fear. Too little serotonin can result in severe depression, accompanied by an inability to sleep, severe fatigue, and needs fixing.


Treatment

To treat hypochondriasis, one must acknowledge the interplay of body and mind. If a person is sick with a medical disease such as diabetes or arthritis, there will often be psychological consequences, such as depression. Some even report being suicidal. In the same way, someone with psychological issues such as depression or anxiety will sometimes experience physical manifestations of these affective fluctuations, often in the form of medically unexplained symptoms. Common symptoms include headaches, abdominal, back, joint, rectal, or urinary pain, nausea,itching, diarrhea, dizziness, or balance problems. Many people with hypochondriasis accompanied by medically unexplained symptoms feel they are not understood by their physicians, and are frustrated by their doctors’ repeated failure to provide symptom relief. Common to the different approaches to the treatment of hypochondriasis is the effort to help each patient find a better way to overcome the way his/her medically unexplained symptoms and illness concerns rule her/his life. Current research makes clear that this excessive worry can be helped by either appropriate medicine or targeted psychotherapy. For other uses, see Suicide (disambiguation). ...


For a long time, hypochondriasis was considered untreatable. However, recent scientific studies show that cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs, e.g., fluoxetine and paroxetine) are effective treatment options for hypochondriasis as demonstrated in clinical trials [5] [6] [7] [8] [9]. CBT, a psycho-educational "talk" therapy, helps the worrier to address and cope with bothersome physical symptoms and illness worries and is found helpful in reducing the intensity and frequency of troubling bodily symptoms. SSRIs can reduce obsessional worry through readjusting neurotransmitter levels, have been shown to be effective as treatments for anxiety and depression, as well as for hypochondriasis. A Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying cognitions, assumptions, beliefs and behaviors, with the aim of influencing disturbed emotions. ... Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants. ...


NIH-funded studies are now underway to compare different treatment approaches for hypochondriasis: a study in the NYC area and a study in the Boston area. In these studies, patients will be given one of four treatments: supportive therapy with fluoxetine, supportive therapy with placebo, cognitive behavior therapy, or cognitive behavior therapy with fluoxetine. For more information you can also visit external links.


In Norway a clinic specializing in the treatment of hypochondria has been opened.


Tips for hypochondriacs

If one is worried about having a serious medical illness despite receiving reassurance to the contrary by a physician during a comprehensive evaluation, it might be beneficial to put these techniques into practice:

  • Keeping a journal describing symptoms or events that led to your episodes of illness should allow one to see the illness clearer.
  • Trying to restrict or put a time limit on one's internet medical research, reading of medical books, or self-checking behaviors, as they tend to increase illness worries.
  • Maintaining a healthy lifestyle, including a good night sleep, well-balanced diet and a positive outlook. A good tip is to follow the PEAS tool sometimes used to combat depression: Pleasure, Exercise, Achievement and Socializing - try to add an aspect of each to daily activities.
  • Practicing relaxation techniques, such as breathing, meditation or other methods may help to decrease anxiety and the effects of stress.
  • Trying to interrupt one's worries with activities that will fully engage one's attention and shift it away from illness; for example, hobbies, word or number games, exercise or walking, talking with a humorous friend, or recalling happy memories.
  • Thinking about alternative explanations for one's physical sensations that might include stress or normal bodily changes.
  • Breaking one's habits of worrying one step at a time.

Pop culture

In the 2001 film Le Fabuleux Destin d'Amélie Poulain (The Fabulous Life of Amélie Poulain), Isabelle Nanty's character Georgette is a hypochondriac. Year 2001 (MMI) was a common year starting on Monday (link displays the 2001 Gregorian calendar). ... Released in 2001, Le Fabuleux Destin dAmélie Poulain (The Fabulous Destiny of Amélie Poulain), or Amélie, as it is known in the English-speaking world, is a quirky French romantic comedy, or a modern fairy tale, starring Audrey Tautou. ...


In the 2005 DreamWorks Animation film Madagascar, a giraffe (Melman) is portrayed as a hypochondriac. Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... DreamWorks Animation SKG, Inc. ... Binomial name Linnaeus, 1758 Range map The giraffe (Giraffa camelopardalis) is an African even-toed ungulate mammal, the tallest of all land-living animal species. ...


On the show South Park, Stan Marsh's father, Randy Marsh, is described by his son as a hypochondriac in the episode "Bloody Mary". This article is about the TV series. ... Bloody Mary is episode 914 of the Comedy Central series South Park. ...


In the film My Girl the leading character Vada is a hypochondriac most likely due to her being raised in a funeral home. My Girl is a 1991 coming-of-age dramatic comedy starring Dan Aykroyd, Jamie Lee Curtis, Macaulay Culkin and Anna Chlumsky. ...


In the film, Bandits, one of the bank robbers (portrayed by Billy Bob Thornton), Terry, is a hypochondriac. The other bank robber, Joe, used this to an advantage once, and claimed that his brother received a brain tumor from smelling burning feathers as a joke to get Terry to worry. Bandits is a 2001 comedy/crime/drama/romance movie directed by Barry Levinson. ... Billy Bob Thornton[1] (born August 4, 1955) is an Academy Award-winning American screenwriter, actor, as well as occasional director, playwright and singer. ...


In the TV series, Scrubs, recurring character Harvey Korman, portrayed by actor Richard Kind, is a hypochondriac that appears in several episodes. His most notable appearance being in the episode, "My New Old Friend". Scrubs is an Emmy- and Peabody Award-winning American situation comedy/comedy-drama that premiered on October 2, 2001 on NBC. It was created by Bill Lawrence and is produced by Touchstone Television. ... A recurring character is a fictional character, usually in a prime time TV series, who is not a main character, but appears from time to time during the series run. ... Richard Kind (b. ... An episode is a part of a dramatic work such as a serial television or radio program. ... List of Scrubs episodes My New Old Friend is the 36th episode of the American sitcom Scrubs. ...


In the 1986 hit film Ferris Bueller's Day Off, Ferris' friend Cameron Frye (portrayed by Alan Ruck) was displaying some symptoms of hypochondria throughout the movie, notably when he is lying in bed thinking he is sick, until Ferris convinces him that it's all in his head. Ferris Bueller redirects here. ... Alan Ruck (born July 1, 1956) is an American stage, television and film actor. ...


In the TV series, Boy Meets World Cory is diagnosed with hypochondria and sees it as a real illness. Boy Meets World is an American television sitcom that chronicled the events and everyday life lessons of Cory Matthews, who grows up from a pre-pubescent boy to a married man. ...


In the book It, Eddie Kaspbrak's mother is a hypochondriac who convinces her son that he is frail and has asthma, even though he does not. She even argues with doctors regarding her son's health. It is a horror novel by Stephen King, published in 1986. ...


See also

This page refers to the self-inflicted factitious disorder. ...

References

  1. ^ American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revised, Washington, DC, APA, 2000.
  2. ^ a b c Fallon BA, Qureshi, AI, Laje G, Klein B: Hypochondriasis and its relationship to obsessive-compulsive disorder. Psychiatr Clin North Am 2000; 23:605-616.
  3. ^ Barsky AJ: Hypochondriasis and obsessive-compulsive disorder. Psychiatr Clin North Am 1992; 15:791-801.
  4. ^ Bienvenu OJ, Samuels JF, Riddle MA, Hoehn-Saric R, Liang KY, Cullen BAM, Grados, MA, Nestadt G: The relationship of obsessive-compulsive disorder to possible spectrum disorders: results from a family study. Biological Psychiatry 2000, 48:287-293.
  5. ^ Barsky AJ, Ahern DK: Cognitive behavior therapy for hypochondriasis: a randomized controlled trial. JAMA 2004; 291:1464-1470.
  6. ^ Clark DM, Salkovskis PM, Hackman A, Wells A, Fennell M, Ludgate J, Ahmand S, Richards HC, Gelder M: Two psychological treatments for hypochondriasis, a randomized controlled trial. Br J Psychiatry 1998; 173:218-225.
  7. ^ Fallon BA, Schneier FR, Marshall R, Campeas R, Vermes D, Goetz D, Liebowitz MR: The pharmacotherapy of hypochondriasis. Psychopharmacol Bull 1996; 32:607-611.
  8. ^ Fallon BA, Qureshi AI, Schneiner FR, Sanchez-Lacay A, Vermes D, Feinstein R, Connelly J, Liebowitz MR: An open trial of fluvoxamine for hypochondriasis. Psychosomatics 2003; 44:298-303.
  9. ^ Greeven A, Van Balkom AJ, Visser S, Merkelbach JW, Van Rood YR, Van Dyck R, Van der Does AJ, Zitman FG, Spinhoven P: Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a randomized controlled trial. Am J Psychiatry 2007; 164:91-99.

External links


  Results from FactBites:
 
Hypochondria - Wikipedia, the free encyclopedia (471 words)
Hypochondria (or hypochondriasis, sometimes referred to as health anxiety or health phobia) is a somatoform disorder in which one has the unfounded belief that one is suffering from a serious illness.
Hypochondria is often characterized by irrational fears of being diseased/dying, obsessions over minor bodily symptoms or imperfections, doubt and disbelief in doctors' diagnosis, constant self-examination and self-diagnosis and preoccupation with one's body.
One trap to be avoided is portraying hypochondria itself as a physiological disease, which may aggravate the situation by confirming the hypochondriac's belief that he or she is in fact ill.
  More results at FactBites »

 
 

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