title: Comorbidity of anxiety disorders and hypochondriasis considering different diagnostic systems.
abstract: The influence of different hierarchical guidelines in various classification systems on the diagnosis of anxiety disorders and hypochondriasis was investigated. Using a semistructured polydiagnostic interview (including DSM-III, DSM-III-R, and the 1987 draft version of ICD-10), lifetime diagnoses were determined in B2 outpatients with a DSM-III-R anxiety disorder. In all diagnostic systems, half of our patients exhibited the descriptive features of hypochondriasis. As demonstrated, the formulation of restrictive hierarchical rules--as in DSM-III--contributes to the concept of "primary" hypochondriasis, while secondary hypochondriasis remains underdiagnosed. Concordance rates for hypochondriasis were high between DSM-III-R and ICD-10, but not with DSM-III. Although hypochondriasis showed a strong association with the clinical course of panic disorder (PD), it could not be explained as a consequence of greater illness severity of PD with agoraphobia (AP). Our data underline the conceptualization of hypochondriasis as a phenomenologically homogeneous diagnostic category that may be differentiated from comorbid psychiatric conditions.
authors.affiliation: Department of Psychiatry, University of Vienna, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Bach
authors.forename: D O
authors.initials: DO
authors.lastname: Nutzinger
authors.forename: L
authors.initials: L
authors.lastname: Hartl
mesh_terms: D000328:Adult; D000368:Aged; D000379:Agoraphobia / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D001008:Anxiety Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006998:Hypochondriasis / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*