The relationship between hypochondriasis and medical illness

Article Abstract:

The term hypochondriasis (hypochondria) refers both to symptoms and to a disorder. The symptoms include fear of disease, belief that one is ill, and experience of physical complaints, all without any medical justification. Hypochondriasis is also a distinct psychiatric disorder that includes all the hypochondriacal symptoms that are not caused by another underlying psychiatric disorder. The relationship of hypochondriasis to illness is not clear, and hypochondriacs may in fact be ill. What distinguishes the hypochondriac is that the fears and symptoms are out of proportion to the actual state of health or illness. It is difficult to determine whether a symptom is psychosomatic or whether there is a medical basis for it. To determine the relationship between hypochondriasis and medical illness, 41 diagnosed hypochondriacs and 75 controls were interviewed, and their medical records were audited. The interview separated reasonable from unreasonable health concerns, so that some patients who were ill were also diagnosed as hypochondriacs. The medical review indicated that hypochondriacs had the same amount of illness as the control patients in the study, and physician ratings of medical status and outcome were essentially the same for both groups. This suggests that hypochondriacs are not sicker than other patients. The medical records of the hypochondriacs did contain more reports of symptoms that could not be diagnosed as a medical condition, probably as a result of more complaints and more contact with physicians. Bodily preoccupations and a belief that one has a disease are more often associated with actual medical illness among those who are not hypochondriacal than among hypochondriacs. Responding appropriately to hypochondriacal patients is difficult, and the clinician must not cause adverse consequences by ordering diagnostic tests that may in themselves cause harm. On the other hand, there is a risk of overlooking an actual illness, and of harming the patient through rejection of the person and of his real suffering. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Hypochondriasis and somatosensory amplification

Article Abstract:

Hypochondriasis is viewed by the compilers of the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-III-R) as a distinct disorder involving the conviction that disease is present when it is not, fear of disease, and a preoccupation with bodily sensations and functions. It may also be conceived of as a disorder of cognition and perception, in which ordinary physical sensations are interpreted as disease states. It has been suggested that medical patients exhibiting a hypochondriacal syndrome generally tend to have a heightened awareness of their senses (amplification). A study of 177 outpatients at Massachusetts General Hospital was conducted to assess the relationship between hypochondriacal symptoms and the tendency to misinterpret benign physical signs and sensations. The subjects (62 percent of whom were women, 92 percent were white, and their average age was 54.2 years) were given a questionnaire designed to measure hypochondriasis, amplification, somatization (the tendency to express emotional problems in the form of bodily symptoms), and beliefs and attitudes toward health and medical care, including fears of aging and death. Statistical analysis of the results revealed that amplification was most strongly related to hypochondriasis, followed by fear of aging and a childhood history of illness. It was also observed that men who are not married are more likely to be hypochondriacal than those who are, while among women, being married was more closely related to hypochondriasis. In addition to excessive sensitivity to bodily symptoms, it appears that hypochondriacs are also more disturbed by such sensations as noise, heat and hunger, and are less tolerant of experimentally induced pain. The authors caution that these findings should not be interpreted to imply a causal connection between amplification and hypochondriasis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Somatoform disorders, Senses and sensation, Senses

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A preliminary report of the short-term effect of carbonated beverage consumption on calcium metabolism in normal women

Article Abstract:

Osteoporosis is a reduction of calcium in the bones of postmenopausal women as a result of decreased sex hormone secretion. The condition causes frailty of the skeleton, increasing the risks of vertebral and other bone fractures. Recently it has become clear that the accumulation of healthy bone mass before the onset of menopause is important in the prevention of osteoporosis. Calcium-deficient diets and excessive alcohol consumption are among the factors that can decrease the reserve of bone mass in women. The short-term effect of nonalcoholic carbonated beverages was investigated in a group of women who received either a standard diet or an experimental diet high in the amount of nonalcoholic carbonated beverages. The two diets were otherwise similar in levels of calcium, phosphorous, vitamins and certain hormones. The women were healthy premenopausal women within 10 percent of ideal body weight, with normal menstruation cycles, and who were not taking any medication known to affect calcium metabolism. A total of eight women finished the study, which showed no demonstrable difference in calcium metabolism and bone measurements as a result of greater ingestion of carbonated nonalcoholic drinks during this short-term experiment. Because of the length of study, the small number of participants and the relatively small increase in carbonated beverage consumption, the validity of this study and the possible adverse effect of consumption of carbonated beverages by women remain in doubt.

Research, Soft drinks, Women, Causes of, Bone diseases, Food and nutrition, Osteoporosis, Calcium in the body, Calcium (Nutrient), Carbonated beverages

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