How to Tell if You’re a Hypochondriac
Are you a full-blown hypochondriac? The American Psychiatric Assn. has six criteria:
* You believe you have a serious disease, based on your misinterpretation of bodily signs or symptoms.
* No doctor can talk you out of this belief.
* You are not delusional; you can admit that you might be exaggerating the extent of your “disease.”
* Your worries cause you significant distress; you have difficulty working, socializing and otherwise functioning.
* This has been going on for at least six months.
* You do not have another psychological condition such as generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, a major depressive episode, or separation anxiety.
Neither the American Medical Assn. nor the American Psychiatric Assn. keeps statistics on the numbers of hypochondriacs (the classic, obsessive type that Dr. Ingvard Wilhelmsen treats). However, there has been research into the related issue of visits to doctors by patients who are overly sensitive to physical sensations and keep coming in and complaining, when there is no organic disease. (Some, but not all, of these patients are classic hypochondriacs. The medical literature refers to them as “somatizers,” “chronic complainers,” “frequent consulters,” “difficult patients” and “hateful patients.”)
Here are some findings:
* One study found that people who “somatize” accounted for 28% of the patients in one solo family practice. They took up 48% of the family doctor’s time.
* The U.S. government’s National Ambulatory Medical Care Survey shows that eight of the somatizer’s favorite complaints--fatigue, back pain, headaches, dizziness, chest pain, shortness of breath, abdominal pain and anxiety--account for about one in seven primary-care visits and 22% of all visits to doctors.
* One study of 14 common symptoms in 1,000 patients at an internal-medicine clinic found that over the course of three years, only 16% of the patients were found to have complaints with an organic cause. Ten percent were found to have psychological causes. For the other 74% of complaints, no cause was ever found.
* Dr. Barry Blackwell, author of a forthcoming book on “the worried well,” believes there is a connection between the increasing ranks of medical sub-specialists, skilled in expensive investigative procedures, and a public tendency to feel sicker and visit doctors, even though statistically the American public is healthier than it used to be. According to Blackwell, the proportion of sub-specialists in the medical work force has increased from 20% in the 1930s to 70% today.
