Hypochondriasis

Hypochondriasis refers to a preoccupation with having or acquiring a serious illness, despite medical reassurance and few or no somatic symptoms. The preoccupation markedly affects daily life and leads to excessive health-related behaviors or maladaptive avoidance. The concern persists for at least six months.

People with this condition may fixate on minor bodily sensations, interpret them as signs of serious disease, seek repeated medical tests or reassurance, and avoid activities for fear of health consequences. Anxiety about illness can be accompanied by distress, sleep disturbance, and impairment in work or social functioning.

In DSM-5, the diagnosis has been reformulated: Illness Anxiety Disorder is used when somatic symptoms are mild or absent, with excessive worry about having a serious illness. Somatic Symptom Disorder applies when significant somatic symptoms are present with disproportionate thoughts and behaviors about health. Medical evaluation is used to rule out actual disease.

Treatment typically includes cognitive-behavioral therapy (CBT) focused on managing health worry, gradual exposure to feared situations, and reducing reassurance-seeking. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) may help if anxiety coexists. Regular, planned follow-up with a clinician rather than repeated testing can be beneficial.

The term hypochondriasis is less used in current diagnostic manuals, having been replaced by Illness Anxiety Disorder and Somatic Symptom Disorder. It remains a common, often chronic condition seen in primary care and psychiatry, with varying prognosis depending on access to care and comorbid conditions.