FLUOXETINE FOR HYPOCHONDRIACAL PATIENTS WITHOUT MAJOR DEPRESSION

Hypochondriasis without concomitant depression is often considered to be unresponsive to pharmacotherapy. Given marked similarities between hypochondriasis and obsessive-compulsive disorder, we decided to condu ct an open trial of high-dose fluoxetine for patients with DSM-III-R h ypochondriasis who did not meet criteria for major depression. Ten of 16 patients were much improved at the end of 12 weeks. A comparison of baseline and week 12 scores by the use of a paired-samples t-test rev ealed a statistically significant reduction in hypochondriacal concern s, as measured by the Heightened Illness Concern Clinical Global Impre ssion Severity scale, the Whiteley Index of Hypochondriasis, and the H eightened Illness Concern Questionnaire. These results suggest that fl uoxetine may be a useful therapy for hypochondriacal patients without marked depressive features-a group previously considered to be treatme nt refractory.