Traditionally, hypochondriasis refers to an excessive fear of having a serious illness, despite medical reassurance and the absence of significant physical symptoms.
Today, the term “hypochondriasis” is retained in the International Classification of Diseases (ICD), while in the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association, it has been divided into two separate disorders: Somatic Symptom Disorder and Illness Anxiety Disorder.

Somatic Symptom Disorder is diagnosed when one or more actual somatic (bodily) symptoms are present, accompanied by excessive worry about them that disrupts normal life functioning.
In contrast, Illness Anxiety Disorder is characterized by preoccupation with having or acquiring a serious illness despite minimal or no somatic symptoms.

 

What Is Hypochondriasis?

Hypochondriasis is marked by a persistent fear or belief that one has one or more serious, potentially life-threatening illnesses.
People with hypochondriasis often misinterpret normal bodily sensations or minor symptoms as signs of serious disease.
For example, a headache may be seen as evidence of a brain tumor, a racing heart as a sign of cardiovascular disease, or stomach pain as a symptom of pancreatic cancer.

As a result, they frequently seek medical consultations, undergo numerous tests on their own initiative, and spend considerable time researching various illnesses.
Alternatively, some may avoid medical care altogether out of fear of receiving bad news.

The symptoms cause significant distress and interfere with personal, family, social, academic, professional, or other important areas of functioning.

People with hypochondriasis may, for much of the time, accept that their beliefs might be incorrect and be open to alternative explanations for their symptoms.
However, in some conditions - such as when anxiety is heightened - insight may temporarily fade.
In other cases, there may be a complete lack of insight, and the person fully believes in the reality of their illness.

Illness anxiety or hypochondriasis can begin at any point in life, though it usually starts after age 30.
It affects about 5% to 7% of adults, with higher prevalence among women, as with many anxiety-related disorders.

The exact causes of hypochondriasis are not clearly understood.
However, contributing factors may include genetics, experiencing or witnessing a serious illness in childhood (either personally or in a family member), childhood trauma such as abuse or neglect, and a history of anxiety or depression.

 

Impact on Life

Persistent fear and anxiety can lead to chronic stress, affecting both physical and mental well-being.
Illness Anxiety Disorder can impair relationships and cause difficulties in daily life.
For example, it may become time-consuming, limiting time spent with loved ones or hindering work performance.

Financial difficulties may arise when a significant portion of income is spent on medical tests and services, especially if work is also affected.
Excessive medical testing can even lead to complications or harm physical health.
On the other hand, avoiding medical care due to fear may result in a real illness going undetected, depriving the person of timely treatment.

 

Treatment

The first-line treatment for hypochondriasis is Cognitive Behavioral Therapy (CBT).
Research shows that two-thirds of individuals who undergo therapy respond positively, and around 50% achieve stable remission (a sustained absence of symptoms).

A key part of therapy is psychoeducation, which helps the individual understand the mechanisms of hypochondriasis and reduce their excessive focus on bodily sensations.

In some cases, antidepressants or even antipsychotic medications may be prescribed to alleviate symptoms and improve functioning.