hypochondria

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Classification according to ICD-10
F45.2 Hypochondriac disorder
ICD-10 online (WHO version 2019)

Hypochondria (from ancient Greek ὑποχόνδρια hypochóndria for the area under the ribs) is, according to the international classification system ICD-10, a mental disorder from the subgroup of somatoform disorders . Those affected suffer from a pronounced fear of having a serious illness without an appropriate, objective finding for it. In addition, hypochondria is a symptom that can also occur in the context of other mental disorders .

Word origin

The original word creation was by Galenos : The term is related to the Greek term χόνδρος chondros for "cartilage". What is meant are the costal cartilages, under ( ὑπό hypo ) which one suspected at that time the origin of the mental illnesses. It was believed that the spleen was responsible for this type of complaint, which is why hypochondria was previously called "spleen addiction".

Everyday usage of the term

In everyday speech, the term hypochondria is used in an unclearly defined manner and has a negative connotation. Hypochondriac is also referred to as the derogatory term for a grouchy or health-concerned person who pays more attention to changes in body functions and also interprets minor body signals as a possible expression of serious illness . In layman's terms, one speaks of an imaginary illness (see Molière , The imagined sick ). This is particularly problematic with regard to those affected by real, clinical hypochondria, since these people are not complacent, but are severely psychiatric and can sometimes experience significant stressful symptoms.

Exaggerated self-observation can lead to misperceptions and frequent doctor visits, even in mentally healthy people, although detailed and repeated examinations do not reveal any physical cause of the symptoms. The easily accessible possibilities of inquiring about symptoms of illness via internet portals lead to new forms of fear of illness, such as what is known as “ cyberchondria ”. Since those affected often experience an intensification of symptoms through intensive research on the Internet , the term Google's disease has also become established in medical jargon .

definition

Unlike in everyday language, hypochondria is clearly defined in the medical sense. The corresponding clinical picture was previously known as hypochondria , but is nowadays defined as a hypochondriac disorder according to the "International Classification of Diseases" ( ICD-10 ) under "F45.2" . In the American classification system DSM-5 , which has been valid since May 2013, the hypochondriac disorder has been replaced by the diagnoses Somatic Symptom Disorder (German: body symptom disorder ) and Illness Anxiety Disorder (German: anxiety disorder ). These two diagnoses take into account that there are two sides of hypochondriacal symptoms that sometimes occur independently of one another, namely medically inexplicable symptoms ( somatoform component) and disease anxiety ( anxiety component ).

There are estimates that every 20th patient suffers from symptoms that cannot be explained by the severity of the impairment from a medical point of view. The prevalence of hypochondria in the sense of a real clinical disorder , however, is significantly lower, and it can also lead to severe courses with over-valued ideas and hypochondriacal delusions . Typically, those affected have already had many medical examinations and often change doctors (called “ doctor hopping ” or “doctor shopping”).

A characteristic of ICD-10 hypochondriac disorder is the fact that the patient is afraid of suffering from a certain disease (e.g. cancer). Complaining about physical symptoms is not in the foreground. Depending on the severity of the symptoms, the person concerned can be more or less convinced by the doctor that his fears are unfounded. The more severe the symptoms, the less it is possible.

If it is sustained, hypochondria is a serious disorder that can be distressing both for those affected and for those around them. According to the results of a large WHO study, Germany ranks among the international frontrunners for high levels of fear of illness. The disease occurs roughly equally in women and men.

In the Anglo-Saxon Science operation is hypochondriasis or certain forms of the disease, contrary to the usual classification as a somatoform disorder, the so-called " forced spectrum " is assigned (engl .: "OCD Spectrum Disorders"). This is especially true when the focus is not on observing body signals, but on the obsessive fear of falling ill. Often with this expression, the doubts so typical of obsessive-compulsive disorder come into play, e. B. in the competence of the doctor or to have understood this correctly. The classification of certain hypochondriac symptom patterns in the spectrum of obsessive-compulsive diseases is more of academic interest, since both diseases can be treated with the same form of behavior therapy and the same medication (especially SSRIs).

diagnosis

According to the ICD-10 diagnostic manual, the predominant characteristic is persistent preoccupation with the possibility of suffering from one or more serious and progressive physical illnesses. Normal or general body perceptions and symptoms are often interpreted as abnormal and dangerous by the patient concerned. Usually only one or two organs or organ systems are in the foreground. Depression and anxiety are common and can warrant additional diagnoses.

In contrast to other psychosomatic patients, patients with hypochondria have more fears and false beliefs about illness, more attention to body sensations, more fears of death and more distrust of the opinions of doctors. This was in spite of the fact that they sought more medical treatments than the other patients. Hypochondria can also be described in the following three dimensions :

  1. Behavior: preoccupation with one's own body
  2. Emotion: Fear of illness
  3. Cognition: Conviction of the presence of an illness, although one's own health is medically reinsured

Subgroups

Specific monosymptomatic forms of hypochondria are:

  • Bromosis(from Latin bromus "stink"): the idea of ​​giving off a bad smell;
  • Parasitosis: Imagination of being infested with parasites (especially worms or spiders) that grow in the body, especially parasites that grow under the skin. (To be distinguished from the dermatozoal delusion in a differential diagnosis ).
  • Dysmorphophobia: The idea of ​​being deformed, disfigured or generally repulsively ugly;
  • Nosophobia:The generalized fear of illness is in the foreground in the nosophobics, regardless of the symptoms. As a rule, they try to “live as healthily as possible” or stay away from other people with illnesses in order to prevent infection .

Differential diagnoses

Since other mental illnesses can also show symptoms that are very similar to classical hypochondria, the diagnosis of an independent hypochondriac disorder should only be made after a detailed differential diagnosis. It is also important to distinguish it from other somatoform disorders (or from diseases that are actually present but not recorded by diagnostics and only " felt " by the patient ). Before diagnosing hypochondria, it must therefore be ruled out whether there are other disorders that better explain the symptoms or whether there are concomitant diseases. Hypochondria as a symptom can occur in the context of the following mental illnesses:

Explanatory models

This article or the following section is not adequately provided with supporting documents ( e.g. individual evidence ). Information without sufficient evidence could be removed soon. Please help Wikipedia by researching the information and including good evidence.

People with hypochondria take her body above average intensive interozeptiv true. They tend to misinterpret these perceptions (see also panic disorder ) and classify them as dangerous. As part of the disorder, attention increases to one's own body and possible symptoms of the disease, which can lead to physiological changes, which in turn can be perceived as threatening. This can lead to a cycle ( feedback ) with cognitive distortion / narrowing.

The latter process can be observed temporarily in all people: New information about or increased awareness (e.g. through AIDS campaigns or in the context of medical studies) for an illness can lead to a greater search for signs of this disease and greater reflection whether one could be sick.

therapy

The Cognitive behavioral therapy is in hypochondriacal disorder, the best so far evaluated and effective treatment. The use of psychotropic drugs ( SSRI ) can be considered.

history

For Thomas Sydenham , hypochondria was synonymous with " hysteria ". Sigmund Freud counted hypochondria together with neurasthenia and anxiety neurosis among the actual neuroses .

See also

literature

  • Susan Baur: The world of the hypochondriac. About the oldest disease in human history. dtv, Munich 1994, ISBN 3-423-30429-4 .
  • Gaby Bleichhardt, Florian Weck: Cognitive behavior therapy for hypochondria and fear of illness. Springer, Berlin 2007, ISBN 978-3-540-46854-7 .
  • Esther Fischer-Homberger: Hypochondria. Melancholy to neurosis: diseases and conditions . Huber, Bern 1970.
  • Ernst L. Kaufs: I'm afraid of illnesses - experiences of a hypochondriac. Tribut , Worms 2006, ISBN 3-9809863-1-4 .
  • Jürgen Margraf: Behavior Therapy. 2: Disorders of Adulthood . Springer, Berlin 2013, ISBN 978-3-662-10774-4 , pp. 43 ( limited preview in Google Book search).
  • John Naish: Hypochondria can be fatal. Handbook for the imaginary ill. Rowohlt, Reinbek near Hamburg 2005, ISBN 3-499-61994-6 .
  • Jan Schweitzer: The sick people . In: Die Zeit , No. 20/2014

Web links

Wiktionary: Hypochondria  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ^ Adelung, Grammatical-Critical Dictionary of High German Dialect , Volume 3. Leipzig 1798, p. 213. on zeno.org
  2. ^ Catherine Belling: A Condition of Doubt. The meanings of hypochondria. New York 2012.
  3. ↑ Lajos Schöne: Google's disease. In: Zahnärztliche Mitteilungen dated February 5, 2014, accessed on June 18, 2014
  4. ↑ DSM-5 redefines hypochondriasis
  5. ↑ Don R. Lipsitt: hypochondriasis: Modern Perspectives on to Ancient Malady. Oxford University Press, Cambridge 2001.
  6. ^ Robert Ernest Hales et al .: The American Psychiatric Publishing textbook of psychiatry. Arlington 2008.
  7. ↑ O. Gureje, TB Üstün, GE Simon: The syndrome of hypochondriasis: A cross-national study in primary care . In: Psychological Medicine . tape 27 , 1997, pp. 1001-1010 .
  8. ↑ a b c José A. Yaryura-Tobias, Fugen A. Neziroglu: Obsessive-compulsive disorder spectrum: pathogenesis, diagnosis, and treatment.
  9. ↑ International statistical classification of diseases, German Modification (ICD-10-GM). In: DIMDI. Retrieved August 17, 2019 .
  10. ^ Henry E. Adams, Patricia B. Sutker (Eds.): Comprehensive Handbook of Psychopathology. 3. Edition. Kluwer, NY 2001, ISBN 0-306-46490-X , p. 237.
  11. ↑ M. Bach, M. Aigner, U. Demal: Hypochondrie - Definition and Classification . In: Spectrum of Obsessive Compulsive Disorders: Research and Practice . Springer, 1998, ISBN 978-3-7091-7502-6 .
  12. ↑ Phobias. In: PSYLEX. Retrieved August 19, 2019 .
  13. ^ Ferdinand Sauerbruch , Hans Rudolf Berndorff : That was my life. Kindler & Schiermeyer, Bad Wörishofen 1951; cited: Licensed edition for Bertelsmann Lesering, Gütersloh 1956, pp. 258–261.
  14. ^ Body Dysmorphic Disorder, Hypochondriasis, Hoarding, and other OCD Spectrum Disorders; Comparing and Contrasting Treatments with OCD Fugen Neziroglu Ph.D., ABBP, ABPP Bio-Behavioral Institute Great Neck, NY
  15. ↑ Alexandra Martin, Martin Härter, Peter Henningsen, Wolfgang Hiller, Birgit Kröner-Herwig, Winfried Rief: Evidence-based guideline on the psychotherapy of somatoform disorders and associated syndromes . In: Evidence-based guidelines for psychotherapy . tape 4 . Hogrefe, ISBN 978-3-8017-2524-2 .
  16. ↑ Ricarda Mewes, Winfried Rief: Somatoform disorders and hypochondria . In: Psychiatry and Psychotherapy Up2date . tape 2 (3) . Georg Thieme, Stuttgart / New York 2008, p. 189-200 , doi : 10.1055 / s-2007-986338 .
  17. ^ BA Fallon: Pharmacotherapy of somatoform disorders . In: Journal of Psychosomatic Research . No. 56 , 2004, p. 455-460 .
  18. ↑ Michele Fornaro, Filippo Gabrielli, Claudio Albano et al .: Obsessive-compulsive disorder and related disorders: a comprehensive survey. In: Annals of General Psychiatry 2009, 8:13.
  19. ↑ Magdalena Frühinsfeld: Brief outline of psychiatry. In: Anton Müller. First insane doctor at the Juliusspital in Würzburg: life and work. A short outline of the history of psychiatry up to Anton Müller. Medical dissertation Würzburg 1991, p. 9–80 ( Brief outline of the history of psychiatry ) and 81–96 ( History of psychiatry in Würzburg to Anton Müller ), p. 37 f.
  20. ↑ Current neuroses . In: Uwe Henrik Peters : Dictionary of Psychiatry and Medical Psychology . 3. Edition. Urban & Schwarzenberg, Munich 1984, p. 16.