The Relationship of Hypochondriasis to Anxiety, Depressive, and Somatoform Disorders
Open accessAbstract
Background Though the phenotype of anxiety about medical illness has long been recognized, there continues to be debate as to whether it is a distinct psychiatric disorder and, if so, to which diagnostic category it belongs.Objective Our objective was to investigate the pattern of psychiatric comorbidity in hypochondriasis (HC) and to assess the relationship of health anxiety to anxiety, depressive, and somatoform disorders.Methods Data were collected as part of a clinical trial on treatment methods for HC. In all, 194 participants meeting criteria for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) HC were assessed by sociodemographic variables, results of structured diagnostic interviews, and validated instruments for assessing various symptom dimensions of psychopathology.Results Most of the individuals with HC had comorbid psychiatric illness; the mean number of comorbid diagnoses was 1.4, and 35.1% had HC as their only diagnosis. Participants were more likely to have only comorbid anxiety disorders than only comorbid depressive or somatoform disorders. Multiple regression analysis of continuous measures of symptoms revealed the strongest correlation of health anxiety with anxiety symptoms, and a weaker correlation with somatoform symptoms; in multiple regression analysis, there was no correlation between health anxiety and depressive symptoms.Conclusion Our findings suggest that the entity of health anxiety (HC in DSM-IV and illness anxiety disorder in DSM-5) is a clinical syndrome distinct from other psychiatric disorders. Analysis of comorbidity patterns and continuous measures of symptoms suggest that its appropriate classification is with anxiety rather than somatoform or mood disorders.
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Health anxiety is an anxiety disorder.
“Health anxiety, an overlapping condition similar to hypochondriasis but not an exact synonym, is an anxiety disorder characterised by excessive fear of having or developing an illness, usually a medical one, with constant health monitoring, bodily checking and, more recently, internet health browsing (cyberchondria).”
From Health anxiety: Detection and treatment (2018) · cites this paper as Scarella et al 2016
The Abstract Conclusion says the findings suggest health anxiety is appropriately classified with anxiety rather than somatoform or mood disorders. The Discussion likewise says it might be better classified as an anxiety disorder. The unqualified claim overstates that tentative classification, particularly since the Introduction notes its DSM-5 placement among somatic symptom and related disorders. (LLM, conf=0.86)
Experimental — accuracy not yet measuredResearch using DSM-IV Hypochondriasis criteria has shown higher levels of comorbidity with anxiety disorders than comorbid depressive or somatoform disorders.
“Research using the DSM-IV Hypochondriasis criteria has shown higher levels of comorbidity with anxiety disorders than comorbid depressive or somatoform disorders [33].”
From Illness Anxiety Disorder: A Review of the Current Research and Future Directions (2024) · cites this paper as [33]
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References 39 · Cited by 93
Research works printed but not linked: 2
- [35]Spielberger CD Gorsuch RL Lushere RE Manual for the State-Trait Anxiety Inventory (Form 4)(Self-Evaluation Questionnaire) Palo Alto, CA Consulting Psychologists Press 1983
- [36]Beck AT Depression Inventory Philadelphia W.B. Saunders 1978
- Authors
- Scarella, T. M., Laferton, J. A. C., Ahern, D. K., Fallon, B. A., & Barsky, A.
- Affiliations
- Brigham and Women's Hospital (US)
- Columbia University (US)
- Corresponding author
- Scarella, Timothy M.
- Venue
- Psychosomatics
- Publisher
- Elsevier BV
- Published
- 2016-03
- Volume
- 57
- Issue
- 2
- Pages
- 200-207
- ISSN
- 0033-3182 (ISSN-L)
- PMC
- PMC4792743
- OpenAlex
- W1829842115
- Cited by
- 93
- References
- 39
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 10 · 2023: 6 · 2022: 8 · 2021: 5 · 2020: 18 · 2019: 13 · 2018: 6 · 2017: 7 · 2016: 4
- FWCI
- 4.60
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIMH, United States (RO1 MH07188, RO1 MH071456)
- German Academic Exchange Service, Germany
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- health anxiety, psychiatric comorbidity, anxiety disorders, depressive disorders, somatoform disorders, symptom dimensions, psychiatric classification
- MeSH terms
- Adult, Depressive Disorder, Female, Humans, Hypochondriasis, Male, Psychometrics, Somatoform Disorders
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