In detail

The hypochondria: the imaginary patient

The hypochondria: the imaginary patient

The hypochondria It is, in essence, an attitude that the individual adopts in the face of illness. The hypochondriacal person is constantly subjected to a thorough and concerned analysis of their basic physiological functions, thinking of them as a source of safe biological disease.


  • 1 Characteristics of hypochondria
  • 2 Symptomatology of hypochondria
  • 3 Diagnosis of hypochondria
  • 4 Treatment of hypochondria

Characteristics of hypochondria

The essential characteristic of hypochondria is the concern and fear of suffering, or the conviction of having, a serious illness, from the personal interpretation of some bodily sensation or other sign that appears on the body. It can occur, for example, with moles, small wounds, coughs, even heartbeats, involuntary movements, or not very clear physical sensations. Although the doctor assures you that he has nothing, the hypochondriac only stays calm for a while, but his concern returns again.

The catastrophic interpretation of body signs most negligible by the individual, is the mechanism that triggers hypochondria. It is known that this disorder often affects family environments, that is, that often several family members tend to be affected. There are families that are especially sensitive and are very inclined towards the interpretation of the signs of disease in all areas of life. In this way, members of the same family learn to interpret any body sign negatively and associate it with anguish, fear or anxiety.

We should not rule out that a hypochondriacal person is really sick. On many occasions, what he does is focus his attention on mild or imaginary symptoms (dizziness, headache, etc.), and not on the really important ones. Likewise, the hypochondriac, by focusing its emotional attention on a specific biological function, may end up forming real organic symptoms (psychosomatic reactions).

Symptomatology of hypochondria

We are faced with a disorder associated very often with the anxiety, so that The main symptom of hypochondria is the exaggerated concern he feels for his health. The hypochondriac constantly meditates on its symptoms, real or imaginary, becoming aware of functional signs that normally escape consciousness (intensity of heartbeat, digestive functions, etc.). You can describe your clinical picture with impressive subtlety, repeatedly clarifying the scope of each of your physical symptoms. The attention of the hypochondriac is focused not only on the study of oneself (the pulse, the temperature, the number of breaths per minute and the blood pressure are taken several times a day), but also on the quantity and composition of the food. It knows with what waters it makes digestion better, what degrees of ventilation or temperature suit it, etc.

In hypochondria, the patient's concerns refer to bodily functions (heartbeat, sweat or peristaltic movements), minor physical abnormalities (small wounds, occasional cough) or vague and ambiguous physical sensations (tired heart, painful veins ...). The individual attributes these symptoms or signs to a dreaded disease and is very concerned about his condition. But in reality there is no medical illness associated with the symptoms, and if the patient is truly ill, his illness is not related to them.

Diagnosis of hypochondria

The hypochondria must be distinguished from being apprehensive; In hypochondria, the discomfort is significant and affects the work, social or other important areas of the subject's life. It should also be considered that the duration of the symptomatology is significant, at least 6 months, before diagnosing said disease.

It must be ensured that the patient does not really have any physical illness. Once it has been ruled out, if the patient continues with anguish, worry and doubts about his state of health, it is convenient to study the possibility of a psychological disorder.

The Diagnostic Research Criteria (ICD 10) for hypochondria they specify that there must be a conviction of "being suffering at most two major medical diseases" and require that at least one of them be correct and specifically named by the individual presenting the hypochondriac disorder.

In psychiatry, the hypochondriac attitude appears as a symptom in some forms of endogenous depression, especially in involuntary melancholy (depression of the elderly). It can also acquire in some cases the features of a delusional development, of hypochondriacal content, in the so-called paranoia hypochondriac A multitude of neurotics, both hysterical, neurasthenic, organoneurotic and psychosomatic patients, highlight in their general clinical picture hypochondriacal attitude.

Hypochondria treatment

In some cases, they are used psychoactive drugs initially to control the anxious symptoms so important that these patients suffer.

Together, you can use a cognitive behavioral psychological therapy, which promotes the loss of anxiety and fear of disease that the hypochondriac feels.

At first, he is asked not to go to the doctor's office or to the hospital emergency department and not to talk about health or illness. For this the collaboration of the patient's family is very convenient, since they have to understand that they have a real problem, although not the one that the patient refers, but another equally worrying one. Once this framework has been established outside the consultation, the psychological treatment itself begins.

As we have already said, the basic treatment consists of lose fear of illness and to death. Many times the anguish produced by the thought of being sick, as an unpleasant and uncontrollable sensation, becomes the trigger for such fear. To achieve the disappearance of these fears, desensitization is used in the imagination to feared and avoided situations, so that finally the patient can approach them without anguish and without fear.

The patient can then begin to reinterpret his bodily sensations and also feel those that are pleasant or neutral and his body ceases to be a source of pain or fear and can become a generator of pleasure and confidence.

Finally, work is done so that the patient can successfully face other problems that appear in their daily lives: making difficult decisions, changing jobs, separations, etc. It is tried to avoid so that in the future situations of depression or continued anguish are triggered that can make him fall into his hypochondriacal problems.

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