Excessive fear of serious illness may lead to premature death, study shows

A large Swedish study found a paradox in people diagnosed with excessive fear of serious illness: They tended to die earlier than those who were not hypervigilant about health problems.

Hypochondriasis, now known as illness anxiety disorder, is a rare disorder with symptoms that go beyond general health concerns.

Despite normal physical examinations and laboratory tests, people with this disease cannot shake off their fear.

Some people may switch doctors repeatedly.

Others may avoid medical care.

Many of us are mildly hypochondriacs. But there are also people at the other extreme, who live with worry, pain and thoughts about having a serious illness, said Dr. Jonathan E. Alpert of Montefiore Medical Center in New York.

Hypochondriasis, now known as illness anxiety disorder, is a rare disorder with symptoms that go beyond general health concerns. Getty Images/iStockphoto

Alpert, who was not involved in the new study, said people with the disease are suffering and it’s important to take it seriously and treat it.

Treatment includes cognitive behavioral therapy, relaxation techniques, education, and sometimes antidepressant medication.

Researchers found that people with the disease are at increased risk of death from natural and unnatural causes, especially suicide.

Hypochondriasis, now known as illness anxiety disorder, is a rare disorder with symptoms that go beyond general health concerns. Getty Images/iStockphoto

Chronic stress and its effects on the body could explain some of the differences, the authors wrote.

The study, published Wednesday in JAMA Psychiatry, addresses an obvious gap in the literature. We are lucky, he says, because the Swedish disease classification system has a separate code for hypochondriasis, allowing analysis of data on thousands of people between 1997 and 2020.

Mattex-Coles said earlier research suggested that people with the disease may be at lower risk of suicide, but our hunch based on clinical experience is that this is not true.

In the study, people diagnosed with suicidality had four times the risk of death by suicide.

They studied 4,100 people diagnosed with hypochondriasis and matched them with 41,000 people of similar age, gender and county of residence.

They used a measure called “person-years,” which takes into account the number of people and how long they were followed.

Overall mortality rates were higher among hypochondriacal patients, at 8.5 and 5.5 per 1,000 person-years, respectively.

People with the disease die earlier than others, with an average age of 70 versus 75.

They are at higher risk of dying from circulatory and respiratory diseases.

Cancer is an exception. The risk of death is about the same.

Researchers found that people with the disease are at increased risk of death from natural and unnatural causes, especially suicide. Associated Press

Alpert, who heads the American Psychiatric Association’s research committee, said patients with excessive anxiety will be cared for by referring them to mental health professionals.

Patients may feel offended because they feel they are being accused of imagining symptoms.

Alpert said great respect and sensitivity need to be conveyed to patients, letting them know that this is a condition in itself and that it has a name. Fortunately, there are excellent treatments.

If you are struggling with suicidal thoughts or experiencing a mental health crisis and live in New York City, you can get free and confidential crisis counseling by calling 1-888-NYC-WELL. If you live outside the five boroughs, you can call the 24/7 National Suicide Prevention Hotline at 988 or visit SuicidePreventionLifeline.org.

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