Dissociative and Somatoform Disorders 367
Fava, Mangelli, & Ruini, 2001). People with panic disorder, phobias, and hypo-
chondriasis all may try to avoid certain stimuli or situations; with panic disorder
and hypochondriasis, what is avoided may be an elevated heart rate (Hiller, Rief, &
Fichter, 2002).
In addition, both patients with hypochondriasis and those with obsessive-compulsive disorder (OCD) have obsessions and compulsions (Abramowitz &
Braddock, 2006). In particular, patients with hypochondriasis obsess about pos-
sible illnesses or diseases they believe they might have. They may compulsively ask
doctors, friends, or family members for reassurance or compulsively “check” their
body for particular sensations. If someone excessively probes, prods, or touches
certain body parts, he or she can create lumps or bruises, which are then interpreted
as a new “symptom” of disease. As Internet use has increased over the last decade,
people with some forms of hypochondriasis spend hours compulsively consulting
medical Web sites. (It’s important to keep in mind that some medically related Inter-
net chat rooms or Web sites can spread false or misleading information.)
Understanding Hypochondriasis
Let’s again consider the neuropsychosocial factors. Most research on understanding
hypochondriasis has examined psychological factors. Neurological and social fac-
tors are only beginning to be the focus of research and so not enough is known to
understand the feedback loops among the types of factors.
Neurological Factors
Neurological factors that are associated with hypochondriasis involve brain systems,
neural communication, and genetics.
Brain Systems Perhaps the most informative study of the brain systems that
underlie hypochondriasis compared patients with this disorder to normal controls
and also to patients who either had panic disorder or OCD (van den Heuvel et al.,
Table 8.15 • Hypochondriasis Facts at a Glance
Prevalence- In the general population, hypochondriasis is rare and its prevalence is unknown. Among
medical patients, 1–5% are diagnosed with this disorder (Magarinos et al., 2002).
Comorbidity- People with hypochondriasis also commonly suffer from an anxiety or depressive disorder or
another somatoform disorder.
Onset- Typically, hypochondriasis begins during early adulthood (Fallon et al., 1993).
- A stressful life event, such as the death of a loved one, can precipitate symptoms of
hypochondriasis (Fallon & Feinstein, 2001).
Course- Over the course of a year, 50% of people with hypochondriasis improve at least to some
degree (Creed & Barsky, 2004; Olde Hartman et al., 2009). - People most likely to recover fully from hypochondriasis do not have another psychological
disorder; their symptoms developed quickly and are mild.
Gender Differences- Nothing defi nitive can be said about whether one gender is more likely to suffer from this
disorder than the other; the handful of relevant studies found contradictory results (Creed &
Barsky, 2004; Toft et al., 2005).
Source: Unless otherwise noted, the source is American Psychiatric Association, 2000.