perfectionism and - Obsessive-Compulsive Foundation

6/14/13
Hypochondriasis – DSM V Changes
• Term “Hypochondriasis” eliminated and renamed
“Somatic Symptom Disorder”
• Dx of SSD must include BOTH:
– Persistent medically unexplained somatic symptoms
(lasting longer than six months)
– Distorted cognitions and attributions:
• High level of health-related anxiety.
• Catastrophic ideas about the state of one’s health
• Belief in the medical seriousness of one's
symptoms despite evidence to the contrary.
• Health concerns and/or symptoms assume a
central role in one's life (ruminative preoccupation).
• When high levels of health anxiety is present without
somatic symptoms, the diagnosis of “Illness Anxiety
Disorder” is given
Hypochondriasis - Clinical Features
• Cognitive Features
– Belief that one has a serious disease or will contract a
serious disease in the future
– Recurrent thoughts and images of disease and death
• Somatic Features
– Anxiety-related bodily reactions (e.g., palpitations)
– Benign bodily sensations and changes (e.g.,
blemishes, mild aches & pains)
• Behavioral Responses
– Repeated checking one’s body for signs of illness
– Repeated reassurance seeking from physicians or
family members
– Repeated requests for medical tests
– Excessive information seeking via books or the
internet
– Avoid or escape disease-related stimuli
Relationship between OCD and HC
Is it Hypochondriasis (HC) or
Health-related OCD
• HC present in 9.5% of a sample of OCD patients
vs. 2.6% of controls (Barsky et al, 1986).
• 34% of a sample of 100 OCD patients had
somatic obsessions that compelled them to seek
medical treatment (Rasmussen & Tsuang,
1986).
• 33% of a sample of 21 HC patients were found
to have lifetime histories of OCD (Fallon et al,
1993c).
SUNDAY
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