HYPOCHONDRIACAL CONCERNS IN DEPRESSED OUTPATIENTS

The relationship between hypochondriacal concerns, as assessed by the Illness Attitude Scales, and depressive symptoms was examined in a sam ple of 100 drug-free outpatients with major depressive disorder. These patients were treated with fluoxetine for 8 weeks, and the effect of treatment on hypochondriacal symptoms was examined. All patients were administered the Structured Clinical Interview for DSM-III-R, the Hami lton Depression Rating Scale, the Symptom Questionnaire, and the Perso nality Disorders Questionnaire-Revised. We found little relationship b et ch een severity of depressive symptoms and hypochondriacal concerns . Measures of anxiety, somatic symptoms, and psychological distress we re more consistently related to these concerns. Similarly, patients wi th either histrionic personality disorder or a lifetime history of pan ic disorder had greater hypochondriacal concerns than patients without these diagnoses. After open treatment with fluoxetine, the degree of hypochondriacal concern showed statistically significant decreases, wh ich were only partly related to the degree of change in depression and anxiety severity. Our findings suggest that the presence of hypochond riacal concerns among depressed outpatients is more closely related to the presence of anxiety than depressive symptoms. The relatively smal l impact of an acute course of antidepressant treatment on hypochondri acal concerns in our sample suggests that these concerns may be enduri ng characteristics modulated only to a limited extent by short term ph armacological alterations of affective state.