Center for Cognitive Therapy
Mark E. Oakley, Ph. D.
Health anxiety includes a spectrum of disorders including hypochondriasis. Health anxiety is characterized by excessive anxiety about one's health. Health anxiety develops and is maintained by a tendency to misinterpret physical symptoms in a catastrophic manner. The prevalence of Hypochondriasis is estimated to be approximately 5% of the population although more mild presentations are much more common.
Hypochondriasis is considered to be a Somatoform Disorder that meets the following criteria:
- Preoccupation with fears of having a disease based on the misinterpretation of bodily symptoms.
- The preoccupation persists despite appropriate medical evaluation and reassurance.
- The preoccupation causes clinically significant distress or impairment in functioning.
- The duration of disturbance persists beyond 6 months.
A related cognitive feature of hypochondriasis involves a hypervigilance for bodily changes that are then misinterpreted as being a sign of a dreaded disease process. Behavioral patterns include repeatedly checking of the body for symptoms, reassurance seeking from physicians or significant others, and repeated requests for medical tests or inquiries into other sources of medical information (e.g. internet searches of medical websites).
Individuals with health anxiety experience many physical symptoms that are real but harmless. People who are perfectly healthy experience similar symptoms and sensations. A major difference between individuals who experience health anxiety from the normal population, even though the symptoms experienced in both groups are similar, is that individuals who suffer from health anxiety are preoccupied with their bodies while those who don't ignore these sensations or attribute them to benign causes.
Health anxiety can be treated effectively in similar ways that other forms of anxiety are treated. Treatment goals for health anxiety typically include:
- Decrease "disease conviction" without necessarily reducing symptoms of concern
- Decreased bodily checking.
- Decreased medical utilization.
- Decreased health related worrying.
- Increased ability to cope with new symptoms.
- Improvements in quality of life.
In addition to Cognitive Therapy to identify and correct inaccurate thinking that underlies and maintains health anxiety, general stress management strategies that have been successfully utilized in Behavioral Medicine approaches are also very helpful.