COMORBIDITY OF ANXIETY DISORDERS AND HYPOCHONDRIASIS CONSIDERING DIFFERENT DIAGNOSTIC SYSTEMS

The influence of different hierarchical guidelines in various classifi cation systems on the diagnosis of anxiety disorders and hypochondrias is was investigated. Using a semistructured polydiagnostic interview ( including DSM-III, DSM-III-R, and the 1987 draft version of ICD-10), l ifetime diagnoses were determined in 82 outpatients with a DSM-III-R a nxiety disorder. In all diagnostic systems, half of our patients exhib ited the descriptive features of hypochondriasis, As demonstrated, the formulation of restrictive hierarchical rules-as in DSM-III-contribut es to the concept of ''primary'' hypochondriasis, while secondary hypo chondriasis remains underdiagnosed. Concordance rates for hypochondria sis were high between DSM-III-R and ICD-10, but not with DSM-III. Alth ough hypochondriasis showed a strong association with the clinical cou rse of panic disorder (PD), it could not be explained as a consequence of greater illness severity of PD with agoraphobia (AP). Our data und erline the conceptualization of hypochondriasis as a phenomenologicall y homogeneous diagnostic category that may be differentiated from como rbid psychiatric conditions. Copyright (C) 1996 by W.B. Saunders Compa ny