The syndrome of hypochondriasis: a cross-national study in primary care.

Abstract

BACKGROUND:

The nature and correlates of hypochondriasis are still poorly understood, especially in settings other than those in North America and Western Europe.

METHODS:

A total of 25,916 consecutive patients making ambulatory visits to primary care clinics at 15 sites in 14 countries were screened using the 12-item General Health Questionnaire (GHQ-12). Based on the screen-score performance, a stratified sample of 5447 of respondents was evaluated at the second-stage (response rate: 62%). Evaluation consisted of physician-rated physical and psychological health status and self-ratings of overall health, physical disability and GHQ-28. Interviewers conducted assessment of psychiatric status, using the Composite International Diagnostic Interview (CIDI) and occupational disability.

RESULTS:

Across the sites, the occurrence of ICD-10 hypochondriasis was 0.8% (95% Confidence Interval, 0.5-1.0%) and over 1.5% at only two sites. A less restrictively-defined form of the disorder had a pooled frequency of 2.2% (95% Confidence Interval, 1.8-2.6%) across the sites. Patients with this abridged hypochondriasis were more likely than those without to have co-morbid major depression and generalized anxiety disorder. They had a poorer perception of their health, were more physically disabled, were more impaired in the performance of occupational role, and were above-average utilizers of health service. Patients with ICD-10 hypochondriasis were no more impaired than those with abridged hypochondriasis.

CONCLUSION:

Even though the ICD-10-defined hypochondriasis is rare, a form consisting of the triad of disease conviction, associated distress and medical help-seeking is present in primary-care settings in different cultures. This syndrome is associated with considerable psychiatric ill-health and functional disability.

• Authors: O Gureje, T B Ustün, G E Simon
• Journal: Psychological medicine (Psychol Med) Vol. 27 Issue 5 Pg. 1001-10 (Sep 1997) ISSN: 0033-2917 [Print] England
• PMID: 9300506 (Publication Type: Journal Article, Multicenter Study)

Topics

• Adolescent
• Adult
• Aged
• Anxiety Disorders (complications)
• Attitude to Health
• Chi-Square Distribution
• Confidence Intervals
• Cross-Cultural Comparison
• Cross-Sectional Studies
• Disabled Persons (statistics & numerical data)
• Female
• Global Health
• Health Status
• Health Surveys
• Humans
• Hypochondriasis (diagnosis, epidemiology)
• Logistic Models
• Male
• Middle Aged
• Odds Ratio
• Patient Acceptance of Health Care
• Prevalence
• Primary Health Care (statistics & numerical data)
• Reproducibility of Results
• Sick Role
• Terminology as Topic