With Poor Insight. This specifier is used if, for most of the time during the current episode, the individual does not recognize that the concern about having a serious illness is excessive or unreasonable.
Associated Features and Disorders
Associated descriptive features and mental disorders. Fears of aging and death are common. Although individuals with Hypochondriasis place greater importance on physical health, they generally have no better health habits (e.g., healthy diet, regular exercise, avoidance of smoking) than individuals without the disorder. The medical history is often presented in great detail and at length in Hypochondriasis.
“Doctor-shopping” and deterioration in doctor-patient relationships, with frustration and anger on both sides, are common. Individuals with this disorder often believe that they are not getting proper care and may strenuously resist referral to mental health professionals. Complications may result from repeated diagnostic procedures that carry their own risks and are costly. However, because these individuals have a history of multiple complaints without a clear physical basis, they may receive cursory evaluations and the presence of a general medical condition may be missed. Social relationships become strained because the individual with Hypochondriasis is preoccupied with his or her condition and often expects special treatment and consideration. Family life may become disturbed as it becomes centered around the individual’s physical well-being. Often, the preoccupation interferes with job performance and causes the person to miss time from work. In more severe cases, the individual with Hypochondriasis may become a complete invalid.
Serious illnesses, particularly in childhood, and past experience with disease in a family member are associated with the occurrence of Hypochondriasis. Psychosocial stressors, in particular the death of someone close to the individual, are thought to precipitate the disorder in some cases. Individuals with Hypochondriasis often have other mental disorders (particularly Anxiety, Depressive, and other Somatoform Disorders).
Associated laboratory findings. Laboratory findings do not confirm the individual’s preoccupation.
Associated physical examination findings and general medical conditions. Physical examination findings do not confirm the individual’s preoccupation.