Predictors of remission in DSM hypochondriasis

Although hypochondriasis is generally believed to be a chronic and refracto ry disorder, relatively little is known about its natural history and cours e. Based on a cognitive/perceptual model of hypochondriasis, we hypothesize d that the disorder would be more chronic in patients who both amplify beni gn bodily symptoms and tend to attribute them to disease. Thirty-eight pati ents with DSM hypochondriasis were assessed with a structured, diagnostic i nterview and self-report questionnaire. A logistic regression model contain ing sociodemographic characteristics and a B-way interaction term composed of the tendency to amplify bodily sensations, the tendency to attribute com mon symptoms to disease, and somatization (all measured at inception) corre ctly classified the remission status of 81.6% of the patients at follow-up 4 years later. These results suggest that patients who somatize, who are am plifiers of bodily sensation, and those who tend to attribute ambiguous sym ptoms to disease have more chronic and more refractory hypochondriasis. It is the co-occurrence of these cognitive and perceptual characteristics, rat her than their occurrence individually, which predicts the persistence of t his disorder. Copyright (C) 2000 by W.B. Saunders Company.