EpistemisHypochondria
Specialty: Psychiatry.
Why it occurs
- Illness anxiety disorder (hypochondria without significant somatic symptoms)
- Somatic symptom disorder (hypochondria accompanied by real but magnified physical complaints)
- Major depressive disorder (hypochondriac ideation that can become delusional in psychotic depression or Cotard syndrome)
- Obsessive-compulsive disorder (rumination about contamination or contracting diseases)
- Panic disorder (extreme hypervigilance at any change in heart or breathing rate)
Initial workup
Short Health Anxiety Inventory (SHAI) Health Anxiety Scale; systematic and rigorous but unique (non-repetitive) exclusion of tumor, cardiac or autoimmune pathologies; assessment of the degree of conviction of the disease (obsessive idea vs. delusional idea).
red flags
Conduct of incessant medical pilgrimage (doctor shopping) that results in the performance of invasive and unnecessary high-risk diagnostic tests, dangerous self-medication or total abandonment of work/family activities to focus one's life on obsessive self-care.
Standard management
- Escitalopram or Sertraline — SSRIs at medium-high doses, very effective in mitigating obsessive ruminations about health and body hypervigilance
- Clomipramine — in refractory cases with a markedly obsessive profile
- Quetiapine or Risperidone at very low doses (as adjuvants to reduce the intensity of the belief if it borders on delirious rigidity).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Psychiatry
- Listed causes
- 5
- Treatment options
- 3