Hypochondriasis: excessive and distressing concern about health. 

Hypochondriac people present an excessive concern about their health, fear of death, and they are constantly self-observing the body functions. Any inconsequential manifestation in their bodies, they interpret it as something that can compromise their health. Do you want to know if you are a potentially hypochondriac person? 

I invite you to answer the following questions. The answers are dichotomous: Yes or No.

1- When someone tells you they have a disease, do you start to find the same or similar symptoms in you? Do you think that you have the same pathology, too?

2- When you hear about diseases, do you start to feel bad, with anxiety, fear or distress?

3- When you notice something unusual in your body as dizziness, a muscular pain or headache, do you think that something is wrong? Do you distress and have to go to the doctor immediately?  

4- Do you visit more than two or three specialists due to the same symptom or discomfort? 

5- Do you frequently search the Internet about diagnostics that you think you have?

6- When you have a discomfort or symptom, do you constantly check it, touch or look?

7- Do people around you think that your attitude and concern about diseases is exaggerated?

If you answered three or more questions affirmatively, it is very likely that you have a hypochondriasis problem. 

What is hypochondriasis?

This consists of the concern, fear or conviction of suffering a serious disease from the non-realistic interpretation of signs or physical sensations. Exaggerated perceivers of bodily sensations, the hypochondriacs amplify them in their minds, with what they trigger torturing mental ruminations of a catastrophic type, which provoke them a constant threat or fear. 

The hypochondriac is characterized by a litany of several complaints, confusing and without much sense. The most common places are the abdominal viscera, the chest, the head and the neck, but they can be in any part of the body or like a general feeling of fatigue and discomfort. Sometimes it is presented a curious mix of specific and thorough complaints with others more diffuse and vague.

Other less obvious and more subtle facts characterize the patient’s behavior. She/he presents her/his complaints with extensive details and with an urgent and insistent pressure to speak. She/he punctuates her/his symptoms signaling the affected parts, or proving what she/he considers an alteration of functioning, or signaling a structural lesion, usually small and insignificant.

Patient’s thoughts are focused on her/his complaints totally, or in her/his unsuccessful attempts to find help and relief. She/he uses the medical terms that has been acquiring in her/his previous contacts with specialist or due to her/his frequent readings of medical texts and articles. The patient is concerned and anxious. It is common that she/he persists in the restlessness, despite it has been given the appropriate medical information and a full support about her/his health. 

Some patients develop a patron of frequent medical visits; others adhere to just one specialist, whom they consult repeatedly on the slightest pretext; and there are those who wander from one specialist to another running endless exams and evaluations. 

It is important recognize that some hypochondriacs provoke in their doctors feeling of frustration and resentment, what makes difficult an objective treatment. The tendency to remit this kind of patients to a colleague or another clinic makes stronger, without any doubt, their natural inclination to multiple consults. 

Somatoform Disorder, actual term for hypochondriasis

Somatoform disorder replaces several diagnostics used before, as the somatic symptom disorder, hypochondria, the undifferentiated somatoform disorder and other related. They all imply somatization, that is to say, the expression of mental factors in the form of physical symptoms, such as: pain, weakness, fatigue, nauseas and other corporal sensations. The person can or cannot suffer a physical disorder that causes the symptoms or contributes to its appearance. 

Doctors were used to diagnosing this type of mental health disorder (sometimes denominated as psychosomatic disorder) when the person referred physical symptoms that were not explained through a physical disorder. Nevertheless, this approach is problematic for several reasons: 

• Sometimes it results difficult for doctors determinate if a person suffers or not a physical disorder.  

• It is not usually correct establish a diagnosis of a mental disorder just because the doctors cannot find a physical cause for the symptoms. It could happen that the results of the tests were wrong or incorrect tests were used.

• Many people can suffer a physical disorder, but it is possible that their reaction to them could be so excessive or inappropriate, what leads one to consider they have a mental health disorder, too.  

• Sometimes, the fact of distinguish between the physical and mental symptoms causes the person thinks that the doctor does not believe his/her symptoms could be real. 

Because of this, nowadays the doctors base the diagnosis of somatoform disorder in the response of the person to his/her symptoms or health problems.

The main criterion to diagnose the somatoform disorder is when the concern of the person for his/her physical symptoms is so strong that provokes a considerable distress and interferes with the development of his/her daily activities. 

It must be clear that the people with this affectation do not produce the symptoms intentionally. Many of them do not realize that they have a mental health disorder, and they are convinced that their symptoms have a physical cause, which requires medical attention. As consequence, they usually continue to put pressure on the doctors to repeat the test or prescribe additional tests, even though after an exhaustive evaluation they have not found nothing at all or nothing truly serious. 

Somatoform disorder diagnosis

The diagnosis is realized based in specific criterions. These are the most important guidelines:

• The person presents symptoms that concern him/her excessively and/or disturb her/his daily routine.   

• She/he constantly thinks in the possible severity of her/his symptoms.

• He/she feels extremely worried about his/her health, which provokes him/her anxiety and distress.

• She/he invests an excessive quantity of time and energy in the health problems.

• The symptoms persist even though the doctors explain them that the exams realized do not yield alarming results. 

To determine if the symptoms are caused by a physical disorder, the doctors will lead a deep exploration and they will usually solicit exams.

This disorder can be overlooked in the case of older adults, because some symptoms as fatigue and pain are considered part of aging, or because the concern is considered understandable in older adults, whom usually present several serious medical problems and take many medicines. 

Cognitive-behavioral therapy is the treatment of choice

Even when the person have a good relation with his/her doctor of primary attention, it is usually refer him/her to a psychiatrics. Psychotherapy is the most efficient treatment, cognitive-behavioral in particular.

For the person with somatoform disorder, maintain a supportive and trusting relation with his/her doctor is beneficial; whom can coordinate the medical attention, offer treatment to relieve the symptoms, visit him/her regularity and avoid him/her unnecessary tests and treatments. 

Nevertheless, the professional must also stay alert to the possibility of the person at any moment can develop an organic disorder that requires and adequate valuation and treatment. It must not be automatically suppose that new and different symptoms are caused by a somatoform disorder.