TRANSIENT AND PERSISTENT HYPOCHONDRIACAL WORRY IN PRIMARY-CARE

We present a 12-month prospective study of hypochondriacal worry in pr imary care. Data were obtained from 546 family medicine patients at th e time of a physician visit for a new illness and again 1 year later. Patients were divided into four groups based on scores on the Illness Worry Scale: non-hypochondriacal (N = 460), transient hypochondriacal (N = 34); emerging hypochondriacal (N = 21); and persistent hypochondr iacal (N = 31). Persistent patients had significantly more serious med ical history but no more serious current illness than those low on ill ness worry. Patients with persistent illness worry were more likely th an others to have a diagnosis of major depression or anxiety disorder, were more likely to believe that their most important significant oth er would pathologize new symptoms, yet were less likely to have been e ncouraged to see the doctor by them. Patients who became less worried over the year reported corresponding decreases in distress, attentiven ess to bodily sensations, emotional vulnerability and pathological sym ptom attributions. We conclude that depressive or anxiety disorders, f ears of emotional instability, pathological symptom attributional styl es and interpersonal vulnerability provide the best prognostic evidenc e for enduring illness worry.