Personality disorders in hypochondriasis: prevalence and comparison with two anxiety disorders.
OBJECTIVE
Symptoms of hypochondriasis are sometimes attributed to personality psychopathology by health care providers. The goals of this study were to assess the prevalence of personality disorder (PD) comorbidity in hypochondriasis (HYP) and to compare the PD comorbidity profile of patients with HYP with that found among patients with other disorders characterized by intrusive thoughts and fears.


METHODS
Structured Clinical Interview for DSM-IV Axis I and Axis II Disorders (SCID-I and SCID-II) were administered to 179 individuals: 62 with HYP, 46 with obsessive-compulsive disorder (OCD), and 71 with social anxiety disorder (SAD). For group contrasts, the samples were "purified" of the comparison comorbid disorders. General linear models were used to test the combined effect of group (HYP, OCD, SAD), age, and gender on the PD outcome variables.


RESULTS
59.7% of HYP subjects had no Axis II comorbidity. The most common PDs in HYP were paranoid (19.4%), avoidant (17.7%), and obsessive-compulsive (14.5%). HYP significantly differed from SAD in the likelihood of a cluster C disorder, whereas no significant difference was noted for HYP vs. OCD. The proportion of subjects having at least two PDs was not significantly different for HYP vs. OCD or for HYP vs. SAD.


CONCLUSIONS
Although 40% of patients with hypochondriasis have PD comorbidity as assessed by the SCID-II, the amount of PD comorbidity is not significantly different than found among individuals with two comparison anxiety disorders. Therefore, health providers should be aware that PD may complicate the clinical profile of HYP, but they should avoid assuming that PD psychopathology is the primary source of hypochondriacal distress.
Department of Psychiatry, Columbia University, New York, NY 10032, USA. baf1@columbia.edu
Brian A
BA
Fallon
Katy M
KM
Harper
Alla
A
Landa
Martina
M
Pavlicova
Franklin R
FR
Schneier
Amanda
A
Carson
Kelli
K
Harding
Kathryn
K
Keegan
Theresa
T
Schwartz
Michael R
MR
Liebowitz
D000328:Adult; D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D001291:Attitude of Health Personnel; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D006998:Hypochondriasis / Q000453:epidemiology* / Q000523:psychology; D007406:Interview, Psychological; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000145:classification / Q000453:epidemiology*; D010817:Physician-Patient Relations; D015995:Prevalence