Definition and Clinical Description | Diagnosis | Epidemiology | Etiology | Treatment
The essential feature in hypochondriasis is preoccupation not
with symptoms themselves but rather with the fear or idea of having
a serious disease, based on the misinterpretation of bodily signs
and sensations (see Table 13–1). The preoccupation persists
despite evidence to the contrary and reassurance from physicians.
Some degree of preoccupation with disease is apparently quite common.
As reviewed by Kellner (1987), 10%–20% of "normal" and
45% of "neurotic" persons have intermittent,
unfounded worries about illness, with 9% of patients doubting
reassurances given by physicians. In another review, Kellner (1985) estimated that 50% of all patients attending
physicians' offices "suffer either from primary
hypochondriacal syndromes or have 'minor somatic disorders
with hypochondriacal overlay'" (p. 822). How these
estimates relate to hypochondriasis as a disorder is difficult to
assess because they do not appear to distinguish between preoccupation
with symptoms (as is present in somatization disorder) and preoccupation
with the implications of the symptoms (as is the case in hypochondriasis).