A recent study conducted in Sweden has revealed a paradoxical finding regarding individuals diagnosed with hypochondria or illness anxiety disorder. The study found that those who are excessively fearful of serious illness tend to have a higher mortality rate compared to individuals who do not exhibit hypervigilance about their health concerns.
Hypochondriasis, now known as illness anxiety disorder, is a rare condition characterized by symptoms that surpass normal health worries. Patients with this disorder experience persistent fears of severe illnesses, despite receiving normal results from physical examinations and laboratory tests. Some even resort to changing doctors repeatedly, while others try to avoid medical care altogether.
Although many individuals exhibit mild hypochondriac tendencies, there are those who live in a state of perpetual worry, suffering, and rumination about being afflicted with a serious illness, as explained by Dr. Jonathan E. Alpert of Montefiore Medical Center in New York. Dr. Alpert, who was not involved in the study, emphasizes the importance of taking the disorder seriously and pursuing appropriate treatment, which can include cognitive behavioral therapy, relaxation techniques, education, and potentially antidepressant medication.
The researchers discovered that individuals diagnosed with hypochondria face an increased risk of premature death from both natural and unnatural causes, particularly suicide. They theorize that chronic stress and its impact on the body may explain part of the observed difference. The study, published in JAMA Psychiatry, addresses a significant knowledge gap in the field. David Mataix-Cols of the Karolinska Institute in Sweden, who led the research, expressed gratitude for the availability of data on thousands of individuals over a 24-year span (1997-2020) due to the presence of a separate diagnosis code for hypochondriasis in the Swedish classification system for diseases.
Previous studies had suggested that individuals with hypochondria might have a lower risk of suicide, but Mataix-Cols explains that based on their clinical experience, they suspected this to be incorrect. Their study confirmed their suspicion, showing that individuals diagnosed with hypochondria had a fourfold higher risk of suicide.
The study included an analysis of 4,100 people diagnosed with hypochondriasis, who were then matched with 41,000 individuals of similar age, sex, and county of residence. The researchers used a measurement known as person years, which considers the number of people analyzed and the duration of the study.
Overall, the individuals with hypochondriasis exhibited higher mortality rates, with 8.5 deaths per 1,000 person years compared to 5.5 deaths per 1,000 person years in the comparison group. Furthermore, those with the disorder tended to die at a younger age, with a mean age of 70 compared to 75 in the control group. The risk of death from circulatory and respiratory diseases was particularly elevated in the hypochondriasis group. However, the risk of cancer-related death was similar in both groups.
Referring excessively anxious patients to mental health professionals requires careful consideration, as pointed out by Dr. Alpert, who heads the American Psychiatric Association’s council on research. Patients may feel offended, perceiving it as an accusation of imagining their symptoms.
Dr. Alpert stresses the importance of approaching patients with utmost respect and sensitivity, conveying the notion that hypochondria is a genuine condition with a name. Fortunately, effective treatments are available to help individuals suffering from this disorder.
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