Hypochondriacal Syndrome

Hypochondria – an inadequate attitude toward one's own health – is observed in all neurotic states. Hypochondria is understood as a painful preoccupation with one's health, a tendency to attribute illnesses to oneself on insignificant grounds

2% of the total number of patients in psychiatric clinics

8% of patients with disorders caused by conflicts

hypochondria «is expressed by excessive fear for one's health, a focus of attention on ideas related to one's own health, and a tendency to attribute to oneself illnesses that do not exist».

Hypochondria is understood as an excessive preoccupation with one's own health, the integrity and functioning of some organ, or, less often, the state of one's mental abilities.

Usually combined with anxiety and depression.

«Hypochondriacal neurosis»

a pathological state involving unjustifiably heightened attention to one's health and conviction of having a severe, incurable illness.

In this case, painful or distressing sensations easily arise in various parts of the body

In neuroses, several obligatory components can be identified:

1. unpleasant or painful sensations,

2. emotional-affective disturbancesand

3. a distinctive mode of thinking

A. Kempinski (1975) considered «a sense of illness and pain» to be among the core symptoms of hypochondria

Hypochondriacal trigger

Sensogenic and ideogenic

Sensogenic hypochondria follows sensory disturbances that undergo psychological processing

Ideogenic hypochondria – false ideas about one's health are formed initially

Pain sensations

V.Ya. Gindikin (1993) identified pain sensations characteristic of hypochondriacal syndromes:

Psychalgias (idiopathic algias) - are a consequence of a raised pain sensitivity threshold and represent situationally conditioned bodily sensations of pain. These sensations usually arise against a background of autonomic disorder symptoms and are accompanied by an affect of anxiety and fear;

Cenesthalgias - pain sensations that patients describe as «burning», «shooting», «throbbing», etc;

Senestopathies - sensations in which unusualness, bizarreness, and distress predominate over actual painfulness (bursting, twisting, peeling, stretching, etc.);

Cenesthesias – sensations of vague bodily unwellness (sudden physical weakness, unsteadiness while walking, lightness and emptiness in the body).

In neuroses, the source of unpleasant sensations are physiological changes in somatic functions caused by normal acts (eating, sleep, physical exertion, emotional strain).

Sometimes – mild somatic changes accompanying the neurosis.

They become particularly significant when incorporated into the structure of the hypochondriacal syndrome

Physiological changes combined with anxious apprehensiveness, caused by excessive concern for one's health and a tendency toward constant monitoring of the activity of internal organs, create the basis for the formation of hypochondria.

Patients persistently present polymorphic complaints of unusual painful sensations in various parts of the body

Thoughts of a severe, incurable illness acquire a dominant, overvalued character,

Going from hospital to hospital and visiting doctors becomes a way of life for such patients

The abundance of somatic complaints does not fit the picture of any particular illness

Character of hypochondriacal complaints: vivid, emotionally charged descriptions

Mental component of the syndrome

Unfounded fear of illness relates to the whole body

Anxious observation of one's own body:

• even the most insignificant physical changes are reinterpretedas symptoms;

• constant checking of indicators (pulse, temperature, stool, blood pressure)

• Lack of trust in bodily functions

• Ego-syntonicsymptomatology

• Avoidant behavior

• A tendency to spare oneself, avoidance of dangers and harmful influences

• A tendency to avoid anything presumed harmful(drafts, coffee, fatty food, etc.)

• Avoidance of physical exertion (sports, sex).

• Withdrawal into oneself (self-observation) and distancing from the surrounding world

• A pronounced loss of the sense of reality (loss of critical judgment) is possible

Specifics of the syndrome

• The hypochondriac's fear is directed at their own body (in phobia – at the outside world)

• Somatic sensation (predominance of observation)

• «Emotional-cognitive» false interpretation (mental state, body image)

• Physical perception (predominance of experiencing)

• Symptom centeredness (hypochondriacal sensation of illness)

• Iatrogenic harm: informative, diagnostic, therapeutic behavior of the doctor

In neuroses, the most common are

• anxious-hypochondriacal,

• depressive-hypochondriacal,

• phobic-hypochondriacal,

• astheno-hypochondriacal,

• obsessive-hypochondriacal