Health ministry of republic of moldova the university of medicine and pharmacy nicolae testemiţanu



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Medical psychology.book (1)

Hypochondriasis disorder
The term hypochondriasis is now defined by DSM-IV and ICD-10 
in terms of disease conviction and disease phobia. DSM-IV describes 
the condition as a "preoccupation with a fear or believe of having a 
serious disease based on the individual interpretation of physical signs 
of sensations as evidence of physical illness. Appropriate physical eva-
luation does not support the diagnosis of any physical disorder than can 
account for the physical signs or sensations or for the individual's 
unrealistic interpretation of them. The fear of having, or belief that one 
has a disease, persists despite medical reassurance." 
Hypochondriasis is characterized by severe anxiety over the possi-
bility of having a disease. A person interprets physical symptoms and 
sensations as signs of a serious medical illness despite medical reassu-
rance that they are not. Hypochondriasis and the other somatoform di-
sorders are among the most difficult and most complex psychiatric di-
sorders to treat in the medical setting. 
The term hypochondria is from the Greek - literally 'below the 
cartilage', referring to the lower ribs and the underlying spleen and liver. 
Its application to mental states comes from the theory of humours, rela-
ting moods to the liver and spleen. In hypochondriasis, this preoccupa-
tion lasts at least 6 months and persists despite appropriate medical eva-
luation and reassurance. 


53 
The diagnosis is suggested by the history and examination and 
confirmed when symptoms persist for more than 6 months and cannot be 
attributed to depression or another psychiatric disorder. 
A person with hypochondriasis may be especially concerned about 
a particular organ system (such as the cardiac or digestive system). A 
doctor's reassurance and even a complete medical evaluation often will 
not calm the person's fears. Or, if it does calm them, other worries may 
emerge days later. 
It generally begins in late childhood and ratio is same for both the 
sex and worry or fear lasts for at least six months.
Hypochondriasis may result in depression, stress, impairment from 
social activity, problem in daily life or nervousness. Patients are not 
lying about their symptoms but they consider that they are sick. Even 
after medical examination they don't accept it. 
Although the exact cause of this problem is unknown, stressful life 
situations may overwhelm a person and contribute to the development of 
generalized anxiety. A history of excessive worry may also be a predis-
posing factor in its development.

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