[Hypochondriasis and cognitive therapy].
BACKGROUND
Hypochondriasis is an annoying disorder. Diagnostic criteria for primary and secondary hypochondriasis as well as comorbidity are explained.


METHODS
Some studies of prevalence, aetiology and treatment are reviewed. Special emphasis is given to the cognitive model.


CONCLUSIONS
The prevalence of primary hypochondriasis in population studies is around 1%, while the prevalence in medical outpatient clinics is 3-4.5%. Several controlled, clinical studies have found positive effect of cognitive-behavioural therapy. Excessive health anxiety that is secondary to depression disappears when the primary disorder is treated. Controlled clinical trials of medication is lacking. Traditionally, hypochondriasis has been considered a difficult diagnosis to present to the patient and hard to treat. Research has increased our knowledge and understanding of the disease, and structured treatment protocols have led to a well founded optimism concerning prognosis. Central themes in the consultations are the question of life and death, interpretation of subjective somatic symptoms and the ability to make decisions when still in doubt.
Wilhelmsen
Ingvard
I
Institutt for indremedisin Diakonissehjemmets sykehus Haraldsplass Universitetet i Bergen 5009 Bergen. ingvard.wilhelmsen@med.uib.no
D015928:Cognitive Behavioral Therapy; D003937:Diagnosis, Differential; D006801:Humans; D006998:Hypochondriasis / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D008954:Models, Biological; D008960:Models, Psychological; D015995:Prevalence; D011379:Prognosis; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy