Hypochondriacal patients' appraisal of health and physical risks

Objective: The authors' goal was to assess the degree to which hypochondria sis is accompanied by a heightened sense of risk of disease and other physi cal hazards. Method: Fifty-six patients meeting DSM-III-R criteria for hypochondriasis w ere compared with 127 nonhypochondriacal patients from the same primary car e setting. Both groups completed a self-report questionnaire assessing the degree to which they felt at risk of developing various medical diseases or being subject to injury from accidents or criminal assault. Results: Both groups of patients exhibited an optimistic bias in that they considered themselves to be less at risk than others of their age and sex. However, the hypochondriacal group had a significantly higher total risk sc ore than did the nonhypochondriacal group. In large part, this intergroup d ifference was the result of the hypochondriacal patients' perception that t hey were likely to develop various diseases. The hypochondriacal group did not score significantly higher than the comparison group in estimating thei r risk of succumbing to accidents and criminal victimization. Perceived ris k was significantly associated with the self-reported tendency to amplify b enign bodily sensa ions. Conclusions: An exaggerated appraisal of risk, jeopardy, and vulnerability to disease may be part of the cognitive distortion seen in hypochondriasis. If this is confirmed, cognitive and behavioral therapies for hypochondrias is may need to include a focus on these patients' understanding and apprais al of risk.