II. Epidemiology
- Peak onset: ages 20 to 40 years
- Prevalence: 2 to 7% in U.S. primary care settings
III. Diagnosis: DSM-V - Illness Anxiety Disorder (replaces Hypochondriasis)
- Meets criteria and is a subset of Somatic Symptom Disorder
- Preoccupation with either contracting or having a serious medical disorder
- SubTypes
- Care-seeking subtype
- Care-avoidant subtype
IV. Diagnosis: DSM IV - Hypochondriasis
- Must meet criteria for a Somatoform Disorder
- Unexplained physical symptoms
- Not due to condition of Secondary Gain (Malingering or Factitious Disorder)
- Causes dysfunction
- Specific criteria for Hypochondriasis
- Nondelusional preoccupation for at least 6 months
- Fixation or fear of a serious or life-threatening medical condition
V. Symptoms
- Patient preoccupied with mild symptoms
- Believes illness is serious or life-threatening
- Angrily rejects reassurance of good health
- Demands further evaluation and treatment
- Shops from physician to physician
- Hyperalert to symptoms
- Presents symptoms in minute detail
- "Knows what the trouble is"
- Wants physician to concur with their self-diagnosis
VI. Associated conditions
- Schizophrenia
- Major Depression
- Dysthymic Disorder
- Organic Brain Syndrome
VII. Differential Diagnosis
VIII. Management
IX. Course
- Chronic life-long illness
X. References
- Tomb (1988) Psychiatry, Williams & Wilkins, p. 96-7