eMedicine Specialties > Pediatrics: Developmental and Behavioral > Medical Topics

Hypochondriasis: Follow-up

Author: Maria Sandra Cely-Serrano, MD, Developmental and Behavioral Pediatrician, Florida Hospital
Coauthor(s): Anna Maria Wilms Floet, MD, Assistant Professor, Assistant Professor of Pediatrics, Department of Pediatrics, Behavior and Developmental, University of Maryland School of Medicine
Contributor Information and Disclosures

Updated: Nov 5, 2008

Follow-up

Further Outpatient Care

  • See Medical Care for information about ongoing treatment in patients with hypochondriasis.

Complications

  • The primary health care provider may overlook an actual medical illness present in an individual with a somatoform disorder because of their history of unfounded symptoms.
  • Complications may result from invasive testing and multiple evaluations employed in the search for the cause of the symptoms. Patients also incur unnecessary hospitalizations, diagnostic tests, medication trials, and surgical procedures.
  • Dependency on pain relievers or sedatives may develop.
  • A poor relationship with the health care provider or evaluation by many providers seems to worsen hypochondriasis.

Prognosis

  • People with somatoform disorders rarely acknowledge that their illness has a psychological component and usually reject mental health treatment.

Patient Education

  • Mental health screening for children and adolescents with persistent reports of headaches, stomachaches, or musculoskeletal pains helps identify and manage somatoform disorders.
  • Psychoeducation always helps manage cases of somatoform disorders. The cost-effectiveness of educational approaches makes them a first-line intervention.

Miscellaneous

Medicolegal Pitfalls

  • Failure to consider an underlying medical condition: The most important differential diagnostic considerations for hypochondriasis are underlying general medical conditions (eg, multiple sclerosis, myasthenia gravis), endocrine conditions (eg, thyroid disease, parathyroid disease), diseases that affect multiple body systems (eg, systemic lupus erythematous), and occult malignancies. Although the presence of a general medical condition does not exclude the possibility of coexisting hypochondriasis, transient preoccupations related to a current medical condition do not constitute hypochondriasis.
 


More on Hypochondriasis

Overview: Hypochondriasis
Differential Diagnoses & Workup: Hypochondriasis
Treatment & Medication: Hypochondriasis
Follow-up: Hypochondriasis
References
[ CLOSE WINDOW ]

References

  1. Bleichhardt G, Hiller W. Hypochondriasis and health anxiety in the German population. Br J Health Psychol. Nov 2007;12:511-23. [Medline].

  2. Noyes R Jr, Stuart S, Langbehn DR, et al. Childhood antecedents of hypochondriasis. Psychosomatics. Jul-Aug 2002;43(4):282-9. [Medline].

  3. Abramowitz JS, Moore EL. An experimental analysis of hypochondriasis. Behav Res Ther. Mar 2007;45(3):413-24. [Medline].

  4. [Best Evidence] Greeven A. van Balkom AJ. Visser S. Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a control randomized trial. American Journal of Psychiatry. jan 2007;164(1):91-9. [Medline].

  5. Thomson AB, Page LA. Psychotherapies for hypochondriasis. Cochrane Database Syst Rev. Oct 17 2007;CD006520. [Medline].

  6. Simon GE, Savarino J, Operskalski B, Wang PS. Suicide risk during antidepressant treatment. Am J Psychiatry. Jan 2006;163(1):41-7. [Medline]. [Full Text].

  7. Abramowitz JS, Deacon BJ. Severe health anxiety: why it persists and how to treat it. Compr Ther. Spring 2004;30(1):44-9. [Medline].

  8. Albrecht S, Naugle AE. Psychological assessment and treatment of somatization: adolescents with medically unexplained neurologic symptoms. Adolesc Med. Oct 2002;13(3):625-41. [Medline].

  9. Barsky AJ, Ahern DK. Cognitive behavior therapy for hypochondriasis: a randomized controlled trial. JAMA. Mar 24 2004;291(12):1464-70. [Medline].

  10. Barsky AJ, Coeytaux RR, Sarnie MK, Cleary PD. Hypochondriacal patients' beliefs about good health. Am J Psychiatry. Jul 1993;150(7):1085-9. [Medline].

  11. Bouman TK, Visser S. Cognitive and behavioural treatment of hypochondriasis. Psychother Psychosom. Jul-Oct 1998;67(4-5):214-21. [Medline].

  12. Campo JV, Jansen-McWilliams L, Comer DM, Kelleher KJ. Somatization in pediatric primary care: association with psychopathology, functional impairment, and use of services. J Am Acad Child Adolesc Psychiatry. Sep 1999;38(9):1093-101. [Medline].

  13. Campo JV, Reich MD. Somatoform disorders. In: Netherton S, Walker CE, Holmes D, eds. Child and Adolescent Psychological Disorders: A Comprehensive Textbook. New York, NY: Oxford Univ Press; 1999:320-43.

  14. Lewis M, ed. Child and Adolescent Psychiatry? A Comprehensive Textbook. Williams & Wilkins; 1996.

  15. Egger HL, Costello EJ, Erkanli A, Angold A. Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains, and headaches. J Am Acad Child Adolesc Psychiatry. Jul 1999;38(7):852-60. [Medline].

  16. Escobar JI, Gara M, Waitzkin H, et al. DSM-IV hypochondriasis in primary care. Gen Hosp Psychiatry. May 1998;20(3):155-9. [Medline].

  17. Fallon BA, Schneier FR, Marshall R, et al. The pharmacotherapy of hypochondriasis. Psychopharmacol Bull. 1996;32(4):607-11. [Medline].

  18. Fritz GK, Fritsch S, Hagino O. Somatoform disorders in children and adolescents: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. Oct 1997;36(10):1329-38. [Medline].

  19. Haugaard JJ. Recognizing and treating uncommon behavioral and emotional disorders in children and adolescents who have been severely maltreated:somatization and other somatoform disorders. Child Maltreat. 2004;May 9(2):169-76. [Medline].

  20. Hiller W, Leibbrand R, Rief W, Fichter MM. Differentiating hypochondriasis from panic disorder. J Anxiety Disord. 2005;19(1):29-49. [Medline].

  21. Hitchcock PB, Mathews A. Interpretation of bodily symptoms in hypochondriasis. Behav Res Ther. May 1992;30(3):223-34. [Medline].

  22. Kellner R. Somatization and Hypochondriasis. New York, NY: Praeger-Greenwood; 1986.

  23. Lieb R, Pfister H, Mastaler M, Wittchen HU. Somatoform syndromes and disorders in a representative population sample of adolescents and young adults: prevalence, comorbidity and impairments. Acta Psychiatr Scand. Mar 2000;101(3):194-208. [Medline].

  24. Livingston R, Witt A, Smith GR. Families who somatize. J Dev Behav Pediatr. Feb 1995;16(1):42-6. [Medline].

  25. Longley SL, Watson D, Noyes R Jr. Assessment of the hypochondriasis domain: the multidimentional inventory of hypochondriacal traits (MIHT). Psychol Assess. 2005;Mar 17(1):3-14. [Medline].

  26. Noyes R Jr, Happel RL, Yagla SJ. Correlates of hypochondriasis in a nonclinical population. Psychosomatics. Nov-Dec 1999;40(6):461-9. [Medline].

  27. Walker LS, Garber J, Greene JW. Somatic complaints in pediatric patients: a prospective study of the role of negative life events, child social and academic competence, and parental somatic symptoms. J Consult Clin Psychol. Dec 1994;62(6):1213-21. [Medline].

  28. Warwick HM, Clark DM, Cobb AM, Salkovskis PM. A controlled trial of cognitive-behavioural treatment of hypochondriasis. Br J Psychiatry. Aug 1996;169(2):189-95. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

hypochondria, hypochondriasis, somatization disorder, hypochondrium, hypochondriac, musculoskeletal pain, depression, emotional disorder, disruptive behavior disorder, anxiety, oppositional defiant disorder, stomachache, attention deficit hyperactivity disorder, ADHD, psychiatric disorders, headache, somatic symptoms, body preoccupation, sexual abuse, learning disability

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Maria Sandra Cely-Serrano, MD, Developmental and Behavioral Pediatrician, Florida Hospital
Maria Sandra Cely-Serrano, MD is a member of the following medical societies: American Academy of Pediatrics and Society for Developmental and Behavioral Pediatrics
Disclosure: Nothing to disclose.

Coauthor(s)

Anna Maria Wilms Floet, MD, Assistant Professor, Assistant Professor of Pediatrics, Department of Pediatrics, Behavior and Developmental, University of Maryland School of Medicine
Anna Maria Wilms Floet, MD is a member of the following medical societies: American Academy of Pediatrics and Society for Developmental and Behavioral Pediatrics
Disclosure: Nothing to disclose.

Medical Editor

Angelo P Giardino, MD, PhD, Clinical Associate Professor, Department of Pediatrics, Baylor College of Medicine; Medical Director, Texas Children's Health Plan, Inc
Angelo P Giardino, MD, PhD is a member of the following medical societies: Academic Pediatric Association, American Academy of Pediatrics, American Professional Society on the Abuse of Children, Harris County Medical Society, Helfer Society, and International Society for Prevention of Child Abuse and Neglect
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

CME Editor

Carrie Sylvester, MD, MPH, Director of Education in Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Pediatrics, Northwestern University Medical School
Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Medical Women's Association, American Psychiatric Association, and American Society for Adolescent Psychiatry
Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD, Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Director of Training, Child and Adolescent Psychiatry Residency Program, University of Southern California Keck School of Medicine
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.