Health anxiety is characterized by excessive worry about one’s health, stemming from beliefs that one’s physical integrity is threatened. Health anxiety ranges from mild and transient to severe and chronic. In its persistent and chronic form, it’s called “hypochondriasis.” People with hypochondriasis are convinced they have a serious disease that has been undetected by medical investigation. Disease conviction arises from misinterpretation of bodily changes and sensations.
Following are clinical features of hypochondriasis:
Cognitive features:
- Disease conviction: belief that one has a serious disease
- Disease preoccupation: recurrent thoughts and images of disease and death
- Hypervigilance for bodily changes
- Difficulty accepting medical reassurance
Somatic features:
- Anxiety-related bodily reactions (e.g., palpitations)
- Benign bodily changes and sensations (e.g., blemishes, mild aches and pains) that are misinterpreted
Hypochondriacal fears:
- Fear of currently having a disease
- Fear of contracting a disease in the future
- Fear or anxiety of exposure to disease-related stimuli
Behavioral responses:
- Repeatedly checking one’s body
- Reassurance-seeking (e.g., from physicians or significant others) that one does not have serious symptoms
- Repeated requests for medical tests
People with health anxiety have 80% more doctors' visits and are very likely to have other problems -- most commonly depression and other anxiety disorders. The typical pattern is to demand "health perfectionism"---every physical discomfort or imperfection is interpreted as a sign of a dreaded disease. In some cases, health anxiety is so severe that the person actually neglects seeing a doctor, feeling certain that an examination will reveal the dreaded news.
About 16.5 % of us have health anxieties, with 5.5% qualifying for the diagnosis of hypochondriasis. Fortunately, it can now be treated effectively with cognitive-behavioral therapy.
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