Specific Culture and Gender Features
Whether it is unreasonable for the preoccupation with disease to persist despite appropriate medical evaluation and reassurance must be judged relative to the individual’s cultural background and explanatory models. The diagnosis of Hypochondriasis should be made cautiously if the individual’s ideas about disease have been reinforced by traditional healers who may disagree with the reassurances provided by medical evaluations. Findings with respect to age and gender differences in prevalence are inconsistent, but the disorder occurs across the lifespan in both men and women.
The prevalence of Hypochondriasis in the general population is 1%-5%. Among primary care outpatients, estimates of current prevalence range from 2% to 7%.
Hypochondriasis can begin at any age, with the most common age at onset thought to be in early adulthood. The course is usually chronic, with waxing and waning symptoms, but complete recovery sometimes occurs. It appears that acute onset, brief duration, mild hypochondriacal symptoms, the presence of general medical comorbidity, the absence of a comorbid mental disorder, and the absence of secondary gain are favorable prognostic indicators. Because of its chronicity, some view this disorder as having prominent “traitlike” characteristics (i.e., a long-standing preoccupation with bodily complaints and focus on bodily symptoms).