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The Relationship Between Hypochondriasis and Medical Illness

The Relationship Between Hypochondriasis and Medical Illness Abstract Forty-one Diagnostic and Statistical Manual of Mental Disor ders-Ill-Revised hypochondriacs were accrued from a primary care practice. Seventy-five control subjects were selected at random from among the remainder of the patients in the same clinic. All subjects completed a structured diagnostic interview and standardized self-report questionnaires. Medical morbidity was assessed with a medical record audit and with primary physicians' ratings. The hypochondriacal and comparison sam ples did not differ in aggregate medical morbidity, although the hypochondriacal sample had more undiagnosed complaints and nonspecific findings in their medical records. Within the compar ison sample, higher levels of medical morbidity were associated with higher levels of hypochondriacal symptoms. This occurred primarily because the most serious medical disorders were as sociated with more bodily preoccupation, disease conviction, and somatization. Within the hypochondriacal sample, no corre lation was found between the degree of hypochondriasis and the extent of medical morbidity. (Arch Intern Med. 1991;151:84-88) References 1. Smith GR, Monson RA, Ray DC. Patients with multiple unexplained symptoms; their characteristics, functional health, and health care utilization . Arch Intern Med. 1986;146:69-72.Crossref 2. Coryell W. Diagnosis-specific mortality: primary unipolar depression and Briquet's syndrome (somatization disorder) . Arch Gen Psychiatry. 1981;38:939-942.Crossref 3. Kellner R. Somatization and Hypochondriasis . New York, NY: Praeger Publishers; 1986:138-144. 4. Stenback A. Hypochondria in duodenal ulcer . Adv Psychosom Med. 1960;1:307-312. 5. Ford CV. The Somatizing Disorders: Illness as a Way of Life . New York, NY: Elsevier Science Publishing Co Inc; 1983. 6. Barsky AJ. The somatoform disorders . In: Kaplan HI, Sadock BJ, eds. Comprehensive Textbook of Psychiatry . 5th ed. Baltimore, Md: Williams & Wilkins; 1989:1009-1027. 7. Pilowsky I. Dimensions of hypochondriasis . Br J Psychiatry. 1967;113:89-93.Crossref 8. Pilowsky I. A general classification of abnormal illness behaviors . Br J Med Psychol. 1978;51:131-137.Crossref 9. Beaber RJ, Rodney WM. Underdiagnosis of hypochondriasis in family practice . Psychosomatics. 1984;24:39-45.Crossref 10. Hanback JW, Revelle W. Arousal and perceptual sensitivity in hypo chondriacs . J Abnorm Psychol. 1978;87:523-530.Crossref 11. Kasteler J, Kane RL, Olsen DM, Thetford C. Issues underlying preva lence of'doctor-shopping' behavior . J Health Soc Behav. 1976;17:328-339.Crossref 12. Dertogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L. The Hopkins symptom checklist (HSCL): a self-report symptom inventory. Behav Sci. 1974;19:1-15. 13. Lipman RS, Covi L, Shapiro AK. The Hopkins symptom checklist (HSCL): factors derived from the HSCL-90 . Psychopharm Bull. 1977;13:4345. 14. Lipman RS, Covi L, Shapiro AK. The Hopkins symptom checklist (HSCL): factors derived from the HSCL-90 . Psychopharm Bull. 1977;13:4345. 15. Barsky AJ, Wyshak G, Klerman GL. Hypochondriasis: an evaluation of the DSM-III criteria in medical outpatients . Arch Gen Psychiatry. 1986;43:493-500.Crossref 16. Robins LN, Helzer JE, Croughan J, et al. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and valid ity . Arch Gen Psychiatry. 1981;38:1443-1445.Crossref 17. Hyler SE, Rieder RO, Spitzer RL, Hendler J, Lyons M. Personality Diagnostic Questionnaire-R . New York, NY: New York State Psychiatric Institute; 1987. 18. Hyler SE, Skodol AE, Kellman HD, Oldham JM, Rosnick L. Validity of the Personality Diagnostic Questionnaire-Revised: comparison with two struc tured interviews . Am J Psychiatr. 1990;147:1043-1048. 19. McKinley JC, Hathaway SR. A multiphasic personality schedule (Min nesota), II: a differential study of hypochondriasis . J Psychol. 1940;10:255-268.Crossref 20. Diener E, Emmons RA. The independence of positive and negative affect . J Personal Soc Psychol. 1985;47:1105-1117.Crossref 21. Costa PT, McCrae RR. Hypochondriasis, neuroticism, and aging . Am Psychol. 1985;40:19-28.Crossref 22. Watson D, Clark LA. Negative affectivity: the disposition to experience aversive emotional states . Psychol Bull. 1984;98:219-235.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

The Relationship Between Hypochondriasis and Medical Illness

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400010100013
Publisher site
See Article on Publisher Site

Abstract

Abstract Forty-one Diagnostic and Statistical Manual of Mental Disor ders-Ill-Revised hypochondriacs were accrued from a primary care practice. Seventy-five control subjects were selected at random from among the remainder of the patients in the same clinic. All subjects completed a structured diagnostic interview and standardized self-report questionnaires. Medical morbidity was assessed with a medical record audit and with primary physicians' ratings. The hypochondriacal and comparison sam ples did not differ in aggregate medical morbidity, although the hypochondriacal sample had more undiagnosed complaints and nonspecific findings in their medical records. Within the compar ison sample, higher levels of medical morbidity were associated with higher levels of hypochondriacal symptoms. This occurred primarily because the most serious medical disorders were as sociated with more bodily preoccupation, disease conviction, and somatization. Within the hypochondriacal sample, no corre lation was found between the degree of hypochondriasis and the extent of medical morbidity. (Arch Intern Med. 1991;151:84-88) References 1. Smith GR, Monson RA, Ray DC. Patients with multiple unexplained symptoms; their characteristics, functional health, and health care utilization . Arch Intern Med. 1986;146:69-72.Crossref 2. Coryell W. Diagnosis-specific mortality: primary unipolar depression and Briquet's syndrome (somatization disorder) . Arch Gen Psychiatry. 1981;38:939-942.Crossref 3. Kellner R. Somatization and Hypochondriasis . New York, NY: Praeger Publishers; 1986:138-144. 4. Stenback A. Hypochondria in duodenal ulcer . Adv Psychosom Med. 1960;1:307-312. 5. Ford CV. The Somatizing Disorders: Illness as a Way of Life . New York, NY: Elsevier Science Publishing Co Inc; 1983. 6. Barsky AJ. The somatoform disorders . In: Kaplan HI, Sadock BJ, eds. Comprehensive Textbook of Psychiatry . 5th ed. Baltimore, Md: Williams & Wilkins; 1989:1009-1027. 7. Pilowsky I. Dimensions of hypochondriasis . Br J Psychiatry. 1967;113:89-93.Crossref 8. Pilowsky I. A general classification of abnormal illness behaviors . Br J Med Psychol. 1978;51:131-137.Crossref 9. Beaber RJ, Rodney WM. Underdiagnosis of hypochondriasis in family practice . Psychosomatics. 1984;24:39-45.Crossref 10. Hanback JW, Revelle W. Arousal and perceptual sensitivity in hypo chondriacs . J Abnorm Psychol. 1978;87:523-530.Crossref 11. Kasteler J, Kane RL, Olsen DM, Thetford C. Issues underlying preva lence of'doctor-shopping' behavior . J Health Soc Behav. 1976;17:328-339.Crossref 12. Dertogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L. The Hopkins symptom checklist (HSCL): a self-report symptom inventory. Behav Sci. 1974;19:1-15. 13. Lipman RS, Covi L, Shapiro AK. The Hopkins symptom checklist (HSCL): factors derived from the HSCL-90 . Psychopharm Bull. 1977;13:4345. 14. Lipman RS, Covi L, Shapiro AK. The Hopkins symptom checklist (HSCL): factors derived from the HSCL-90 . Psychopharm Bull. 1977;13:4345. 15. Barsky AJ, Wyshak G, Klerman GL. Hypochondriasis: an evaluation of the DSM-III criteria in medical outpatients . Arch Gen Psychiatry. 1986;43:493-500.Crossref 16. Robins LN, Helzer JE, Croughan J, et al. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and valid ity . Arch Gen Psychiatry. 1981;38:1443-1445.Crossref 17. Hyler SE, Rieder RO, Spitzer RL, Hendler J, Lyons M. Personality Diagnostic Questionnaire-R . New York, NY: New York State Psychiatric Institute; 1987. 18. Hyler SE, Skodol AE, Kellman HD, Oldham JM, Rosnick L. Validity of the Personality Diagnostic Questionnaire-Revised: comparison with two struc tured interviews . Am J Psychiatr. 1990;147:1043-1048. 19. McKinley JC, Hathaway SR. A multiphasic personality schedule (Min nesota), II: a differential study of hypochondriasis . J Psychol. 1940;10:255-268.Crossref 20. Diener E, Emmons RA. The independence of positive and negative affect . J Personal Soc Psychol. 1985;47:1105-1117.Crossref 21. Costa PT, McCrae RR. Hypochondriasis, neuroticism, and aging . Am Psychol. 1985;40:19-28.Crossref 22. Watson D, Clark LA. Negative affectivity: the disposition to experience aversive emotional states . Psychol Bull. 1984;98:219-235.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1991

References