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Experts
Say Hypochondria Is Real
Excerpt
By Melinda T. Willis, ABCNews.com
Hypochondria is often the brunt
of many jokes, but experts say it is a real and treatable disorder.
The recent anthrax scares have made nearly everyone a little
more worried about those sniffles and coughs, leading many people
to joke about hypochondria. But experts say hypochondriasis is
a real disorder that puts a strain on the medical system and is
no laughing matter.
A person who suffers from hypochondriasis believes that his or
her physical symptoms, either real or imagined, are signs of a
much more serious illness, despite medical reassurance that they
are not. According to experts, the prevalence of hypochondria
ranges from 4 percent to 7 percent in the general population,
affecting both men and women equally.
"Most people who notice a mole on their shoulder that is changing
color [and] that they think may be skin cancer will go to the
doctor who tells them that it is nothing. And they say, 'Great,
I'm outta here,' says Dr. Arthur Barsky, director of psychiatric
research at Brigham and Women's Hospital in Boston, who reviews
hypochondriasis in this week's issue of The New England Journal
of Medicine. "That sort of information and reassurance is
not helpful to a person suffering from hypochondriasis."
Instead, a hypochondriac will become angry with the physician
for failing to realize that the person does indeed have a problem,
says Barsky.
Some research suggests hypochondriacs may be more finely tuned
to their bodies and have a tendency to misinterpret symptoms that
others would overlook.
"Hypochondriacs tend to [believe they] suffer from diseases
that aren't always clear and where a diagnosis is often difficult,"
says Dr. Brian Fallon, director of the Somatic Disorders Research
Program at the New York State Psychiatric Institute.
Poorly Understood
Although hypochondriasis is a very common problem in clinical
practice, Barsky notes there isn't much known about how to deal
with it.
While hypochondriasis is regarded as a psychiatric disorder,
psychiatrists rarely see patients who suffer from it. From the
perspective of the patients, their problems are a medical concern
and they are generally very reluctant to see a mental health professional
if their physician suggests it.
"That's like saying they're making it up," says Fallon.
As a result, hypochondriacs become a huge drain on the medical
system. "They are very expensive to take care of," says Barsky.
"They use a disproportionate amount of services and it doesn't
do any good. They are not assured."
Hypochondriacs have disproportionately high rates of visits
to physicians, specialty consultations, surgical procedures and
lab tests.
Treatment Options
One treatment strategy for hypochondriasis is cognitive-behavioral
therapy in which patients try to alter their beliefs about illness
and symptoms and seek to understand how their behaviors play a
role in the disorder.
A second strategy is pharmacotherapy or treatment with medications
such as Prozac.
According to Barsky, two-thirds of hypochondriacs have co-existing
psychiatric illnesses such as major depression, panic disorder,
and obsessive-compulsive disorder. Treatment of these underlying
conditions has been shown to alleviate hypochondriasis.
Additional research by Fallon shows that regardless of whether
there is an underlying condition, hypochondriacs can be treated
with medication.
"Seventy to 80 percent of people who have hypochondriasis benefit
significantly from pharmacological treatment," says Fallon.
Other strategies include developing supportive relationships
between physicians and patients and using techniques to assure
the patient their concerns are being regarded.
"The good news about hypochondriasis is that it's treatable,"
adds Fallon.
Reference
Source 104
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