PSYCHIATRIC COMORBIDITY AMONG PATIENTS WITH HYPOCHONDRIASIS

The purpose of this study was to determine the nature and extent of co morbidity among patients with DSM-III-R hypochondriasis and to examine the relationships between this disorder and coexisting psychiatric il lness. For this purpose, patients seen in a general medicine clinic we re screened using measures of hypochondriacal attitudes and somatic sy mptoms. Those scoring above an established cutoff were given a structu red diagnostic interview. In this manner, 50 patients who met DSM-III- R criteria for hypochondriasis and 50 age- and sex-matched controls we re identified. The presence of other psychiatric disorders (current an d past) was determined by means of the same diagnostic interview. More hypochondriacal subjects (62.0%) had lifetime comorbidity than did co ntrols (30.0%). Major depression, the most frequent comorbid disturban ce, was usually current and most Often had an onset after that of hypo chondriasis. Panic disorder with agoraphobia, the most frequent anxiet y disorder, was also current but Often began before or at the same tim e as hypochondriasis. Few subjects met criteria for somatization disor der but a third qualified for a subsyndromal form of this disorder. Th e data show that, in medical outpatients with hypochondriasis, mood an d anxiety disorders frequently coexist. This comorbidity is subject to varying interpretations including overlap of symptom criteria, treatm ent-seeking bias, and the possibility that hypochondriasis predisposes to or causes the comorbid disorder, as seems likely in the case of de pression. In some instances hypochondriasis may be an associated featu re of another illness.