Hypochondria is a condition characterized by excessive worry or anxiety about one’s health. People with hypochondria may be preoccupied with the belief that they have a serious illness, even when there is no evidence to support this. They may also be overly focused on minor health concerns.

Hypochondria can be a debilitating condition that interferes with daily life. People with hypochondria may avoid activities and social interactions for fear of becoming ill.

They may also miss work or school due to their constant worry about their health. In severe cases, people with hypochondria may become housebound. Treatment for hypochondria typically involves cognitive-behavioral therapy and medication.

Hypochondria thus represents the expression of the patient’s struggle against his suffering and translates into the fear of having a serious illness.

There may be other associated disorders such as anxiety or depression.

Hypochondria seems to be more common in the elderly, which may be related to social isolation.

Hypochondria is found in different types of psychological disorders: neurosis, psychosis, depression.

According to the American classification of mental disorders, hypochondria includes a preoccupation centered on the fear or idea of ​​having a serious illness, based on the subject’s misinterpretation.

The concern may relate to either bodily functions such as heartbeat, sweating, digestive transit, or minor physical disturbances such as a sore or the occasional cough.

Clinical

It is the general practitioners who will be the first to be confronted with these localized complaints.

The hypochondriac constantly studies and analyzes the functioning of his body and transcribes it in a medicalized language.

The affected organs are difficult to explore. Digestive, cardiac, respiratory and urinary functions are often affected, as well as headaches.

The patient’s description of his disorder is precise and well explained. It will gradually invade the existence of the subject with negative consequences on the entourage of the individual.

During an anxiety neurosis, an obsessive disorder or a depressive disorder, the subject is preoccupied with the alteration of the organ or its transformation.

In the elderly, Cotard’s syndrome can develop with delusions that set in such as the fact that the intestine no longer works.

Hypochondria can also be found in paranoid delusions where doctors are perceived as persecutors because they have been treated poorly.

Delusions of late onset in the elderly can take on the mask of hypochondriacal delusions. They are accompanied by food disturbances when they concern the digestive sphere. In delirium, it is mostly denial that is present.

Treatment

The treatment is most often very difficult and requires above all to make the diagnosis of hypochondria to establish a good relationship between the patient and the doctor. The treatment of the cause is a priority: depression, anxiety or delirium.

Medications prescribed are antidepressants and antipsychotics to decrease inhibition, withdrawal and rumination.

There are several effective non-pharmacological treatments for hypochondria, including cognitive behavioural therapy (CBT), medication, and self-help strategies. CBT helps people to challenge their negative thoughts and behaviours. Medication can be used to treat any underlying anxiety or depression. Self-help strategies such as relaxation techniques and exercise can also be helpful in managing symptoms.

Practical case of hypochondria

Jacques, 72 years old, has been complaining for two years of diffuse abdominal pain which has prompted several medical consultations. He is described by those close to him as being very anxious, psychorigid, often concerned about his health. Following a bad fall two years earlier, he had to stop his daily walk for fear of falling again. He is focused on his abdominal pain which he describes in detail and also complains of constipation and diarrhoea. He is convinced that he has cancer, the prognosis of which is hidden from him by the doctors.

Arguments in favor of hypochondria are:

• Obsessive personality trait;
• permanent anxiety ;
• the difficult work of mourning an aging body;
• persistence of symptoms over time;
• nosophobia;
• a treatment combining antidepressants and relaxation is proposed to him.