Hypochondria: what is it, symptoms, treatment, prognosis, complications

What is hypochondria?

Hypochondria(as well as hypochondriacal disorder, hypochondriac syndrome) Is a mental disorder defined by excessive anxiety about the presence or development of a serious undiagnosed illness. People with hypochondriacal disorder experience persistent anxiety or fear of developing an illness or serious medical illness that adversely affects their daily life. This fear persists despite normal physical examinations and laboratory results. People with hypochondria place undue emphasis on normal bodily sensations (for example, digestive or sweating functions) and misinterpret these sensations as indicators of severe diseases. Hypochondriacal syndrome is usually a chronic condition.

The disorder is common in non-gender-dominated adolescents and usually worsens with age, but it is also more common in unemployed and less educated people.

Causes and risk factors

The exact etiology of the disorder remains largely unknown. However, several risk factors are involved in the development of this disorder.

• People with hypochondria may be uncomfortable with normal bodily sensations and may interpret minor bodily changes as pathological.
• If the person grew up in a family where health concerns are often discussed, or if the parents were disproportionately concerned about health problems, the disorder may develop.
• A person may be at an increased risk of developing hypochondria if they had a serious illness during childhood or if their parents or siblings had a serious illness.
• People with an underlying anxiety disorder (such as generalized anxiety disorder) are also at increased risk.
• If a person spends an inordinate amount of time researching health-related materials online, they may be at an increased risk of developing hypochondriacal syndrome.

Signs and symptoms

People with hypochondriacal syndrome often seek primary care from their primary care physician rather than a psychiatrist. The diagnosis is usually first suggested by primary care physicians when, despite a normal physical examination, laboratory research and repeated reassurances, patients continue to have grave concern and anxiety about the underlying serious diseases. These patients often have no somatic symptoms. If somatic symptoms are present, they are minor. If another medical condition is present, the concern about one's health is clearly excessive and disproportionate to the severity of the condition.

Patients with hypochondria are usually dissatisfied with negative test results and see several doctors for the same medical problem. They believe that their previous doctors were either incompetent or ignored the details and overlooked a serious illness that would have dire consequences. Patients may also find that they often check their body for skin damage, hair loss, or physical changes. They may also think too much about death and disability. They are so preoccupied with their body-controlling behaviors and health problems that their social and professional functioning can be significantly impaired.

Most patients with hypochondria are of one of two types:

1. Type seeking examination and treatment. These patients often seek help from the health care system and change doctors all the time. They may ask for several tests and treatments.
2. A type that avoids examination and treatment. These patients avoid medical attention. They are very anxious to believe that a primary care physician or laboratory tests will identify a life-threatening disease (such as cancer).

General health does not preclude a diagnosis. General medical illness and hypochondria can be associated diagnoses. When a medical disorder is present, hypochondriacal syndrome is considered when health-related anxiety / concern is disproportionate or excessive compared to the general somatic disease.

Diagnostics

Hypochondriacal disorder is a diagnosis of exclusion. Before a diagnosis is made, the patient undergoes a comprehensive medical examination and an appropriate examination in accordance with the patient's symptoms in order to exclude organic diseases. The disorder may be accompanied by symptoms of severe anxiety or obsessive-compulsive symptoms. When diagnosing, it is necessary to consider the possibility that the person suffers from another mental disorder, with which may develop fear or exaggerated concerns about a physical illness, for example, various shape depression, schizophrenia or a somatisation disorder.

Treatment

Treatment of patients with hypochondria is primarily aimed at helping patients cope with health concerns. Primary care physicians should strive to establish rapport and therapeutic an alliance with patients so that patients feel comfortable discussing their concerns with health. Patients' fears and concerns should be recognized. You should avoid statements such as "it's all in your head." If necessary, the patient can be referred to other healthcare professionals. Once a serious illness has been ruled out and a diagnosis has been made, overuse should be avoided. medical system, unnecessary imaging tests, referrals and laboratory research. Ideally, these patients are referred to a psychiatric specialist. The primary care physician must do this in a tactful and unbiased manner so that patients do not feel abandoned. Patients should be scheduled for regular follow-up by their doctor and psychiatrist. Frequent observation will reduce the number of visits to the emergency room or other doctors. It will also allow the clinician to critically assess new complaints and associated triggers and stresses.

Psychotherapy is the first line treatment for hypochondriacal disorder. Cognitive behavioral therapy (CBT) is a type of psychotherapy that focuses on treating a patient's dysfunctional cognitive beliefs through behavior modification strategies. This may be due to the patient's habit of over-checking the body for signs of illness. CBT also includes teaching about normal somatic sensations and their normal variations. Mindfulness-based cognitive therapy, group therapy, and acceptance and adherence therapy can also be applied.

Pharmacological drugs are second-line drugs for the treatment of hypochondria. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SSRIs) have been shown to be effective. Patients who respond to antidepressant therapy are advised to receive supportive care for at least 6–12 months. Most patients require a combination of psychotherapy and pharmacological agents.

Forecast

The prognosis of hypochondria is better in those who were referred for early psychiatric evaluation than in those who received only general care. In addition, research shows that patients who are cooperative, patient, and hopeful tend to have better outcomes. If the patient responds well to psychotherapy, medication, or both, the prognosis can be moderate to good. However, if a patient has severe symptoms of hypochondria that do not respond to treatment with psychiatric drugs and psychotherapy, the prognosis becomes poor.

Complications

Hypochondriacal disorder can significantly affect a patient's personal life and relationships. This interferes with the patient's normal functioning in daily life and can cause serious disability. In addition, due to frequent fears of getting sick, patients can often take leave from work, which causes problems in their professional activities. Further complications include financial hardship due to frequent doctor visits and medication purchases. Patients are also at high risk of developing other mental illnesses, such as major depressive disorder or personality disorder.