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 .
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".
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 .
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 In the American classification system DSM-5 , which has been valid since May 2013, the hypochondriac disorder has been replaced by the diagnoses Somatic Symptom Disorder (German: body symptom disorder ) and Illness Anxiety Disorder (German: anxiety disorder ).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).
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 :
- Behavior: preoccupation with one's own body
- Emotion: Fear of illness
- Cognition: Conviction of the presence of an illness, although one's own health is medically reinsured
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 .
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:
- Delusional disorder
- Obsessive-compulsive disorder
- Anxiety disorder
- Conversion disorder
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.
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