204 Hypochondriasis (300.7)
DSM -IV-TR criteria
A. Preoccupation with fears of having, or the idea that one has, a serious disease based on the person’s misinterpretation of bodily symptoms
B. The preoccupation persists despite appropriate medical evaluation and reassurance.
C. The belief in Criteria A is not a delusional intensity (as in Delusional Disorder, Somatic Type) and is not restricted to a circumscribed concern about appearance (as in Body Dysmorphic Disorder).
D. The preoccupation cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
E. Duration of disturbance at least six months.
F The preoccupation is not better accounted for by Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, a Major Depressive episode, Separation Anxiety or other Somatoform Disorder.
Specify if: With Poor Insight: if for most of the time during the current episode, the person does not recognize that the concern about having a serious illness is excessive or unreasonable.
Barlow and Durand (2009) give an example of hypochondriasis:
Gail was married at 21 and looked forward to a new life. As one of many children in a lower-middle-class household, she felt weak and somewhat neglected and suffered from low self-esteem. An older stepbrother berated and belittled her when he was drunk. Her mother and stepfather refused to listen to her or believe her complaints. But she believed that marriage would solve everything; she was finally someone special. Unfortunately, it didn’t work out that way. She soon discovered her husband was continuing an affair with an old girlfriend.
Three years after her wedding, Gail came to our clinic complaining of anxiety and stress. She was working part-time as a waitress and found her job extremely stressful Although to the best of her knowledge her husband had stopped seeing his former girlfriend, she had trouble getting the affair out of her mind.
Although Gail complained initially of anxiety and stress, it soon became clear that her major concerns were about her health. Any time she experienced minor physical symptoms such as breathlessness or a headache, she was afraid she had a serious illness. A headache indicated a brain tumor. Breathlessness was an impending heart attack. Other sensations were quickly elaborated into the possibility of AIDS or cancer. Gail was afraid to go to sleep at night for fear that she would stop breathing. She avoided exercise, drinking, and even laughing because the resulting sensations upset her. Public restrooms and, on occasion, public telephones were feared as sources of infection.
The major trigger of uncontrollable anxiety and fear was in the new in the newspaper and on television. Each time an article or show appeared on the “disease of the month,” Gail found herself irresistibly drawn into it, intentionally noting symptoms that were part of the disease. For days afterwards she was vigilant, looking got the sympto