Hypochondriacal patients, their physicians, and their medical care
Abstract
Objective To examine the views hypochondriacal patients have of their physicians, and their physicians' assessments of the hypochondriacal patients.Design A sample of patients meeting DSM-III-R diagnostic criteria for hypochondriasis was obtained by screening consecutive medical outpatients. They underwent a battery of self-report questionnaires and structured interviews, their medical records were audited, and their physicians completed questionnaires about them. A random sample of nonhypochondriacal patients from the same clinic served as a comparison group.Setting A large general medicine outpatient clinic of an academic teaching hospital.Patients 41 DSM-III-R hypochondriacs and 71 comparison patients.Measurements and main results Hypochondriacal patients were more dissatisfied with their physicians than were comparison patients. Physicians rated the hypochondriacal patients as more frustrating to care for, more help-rejecting, and more demanding. Physician ratings of how hypochondriacal their patients were correlated significantly with their ratings of how frustrating they considered the patients (R2 = 0.36) and with objective measures of how hypochondriacal the patients were (incremental R2 = 0.08). Physician estimates of anxiety and depression in the hypochondriacal patients were not statistically related to patient anxiety and depression. In contrast, physician estimates of patient anxiety and depression were significantly associated with the presence of anxiety and depression in comparison patients.Conclusions The physician's use of the term hypochondriasis is closely associated with his or her frustration with the patient and is associated with objective measures of the extent of hypochondriacal symptoms. In addition, the presence of DSM-III-R hypochondriasis impairs the physician's accuracy in assessing the levels of the patient's anxiety and depression.
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Mistrust of professionals may be more relevant in samples with pathological levels of HA.
“In addition, it is conceivable that this aspect may be more relevant in samples with pathological levels of HA, given that the relationships between physicians and highly health-anxious patients are often difficult and characterized by dissatisfaction [96].”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [96]
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- Authors
- Barsky, A. J., Wyshak, G., Latham, K. S., & Klerman, G. L.
- Affiliations
- Harvard University (US)
- Massachusetts General Hospital (US)
- Cornell University (US)
- Venue
- Journal of General Internal Medicine
- Published
- 1991-09
- Volume
- 6
- Issue
- 5
- Pages
- 413-419
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- OpenAlex
- W2065033768
- Cited by
- 68
- References
- 34
- Citations by year
- 2025: 2 · 2023: 1 · 2022: 1 · 2021: 3 · 2019: 1 · 2018: 2 · 2016: 2 · 2015: 2 · 2014: 1 · 2013: 3 · 2012: 2
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH 40487, R01MH040487)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
- Keywords
- health anxiety, physician-patient relationship, physician frustration, patient dissatisfaction, anxiety, depression, health care utilization, DSM-III-R diagnosis
- MeSH terms
- Attitude of Health Personnel, Female, Health Services, Humans, Hypochondriasis, Male, Middle Aged, Physician-Patient Relations, Surveys and Questionnaires, Patient Satisfaction
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Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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