HYPOCHONDRIASIS AND ILLNESS PHOBIA IN PANIC-AGORAPHOBIC PATIENTS

In a sample of 131 patients with panic disorder, we explored both the presence of DSM-III-R criteria for hypochondriasis and the occurrence of illness phobia before the onset of panic disorder. To explore furth er the possible relationship between hypochondriacal features and pani c-agoraphobic syndrome, we compared patients both with and without cur rent hypochondriasis and then patients both with and without illness p hobia before the onset of panic disorder. Finally, we investigated the relationship between premorbid phobic-anxious traits and hypochondria sis during panic disorder. No differences were found between patients with and without hypochondriasis, either in terms of clinical features or in the course of panic disorder. patients with illness phobia befo re the onset of panic disorder reported higher levers of anticipatory anxiety in nonagoraphobic situations and more depersonalization and de realization during panic attacks, and they met our definition of phobi c-anxious temperament more frequently than the rest of the sample. Thi s would suggest that illness phobia before the onset of panic disorder may be viewed either as a separate disorder, a prodrome, or a mild, e arly-onset form of panic disorder without full-blown attacks. Although patients with premorbid illness phobia are more likely to develop hyp ochondriasis after the onset of panic disorder, approximately 40% of t hem do not; therefore, illness phobia should not be considered the onl y factor that influences the development of hypochondriasis during pan ic disorder. Copyright 1997 by W.B. Saunders Company.