In a hypochondriasis paradox, people who worry about getting seriously ill have higher mortality rates, Swedish study finds

Author: Kara K. Johnson

A hospital exam room in Alabama on Thursday, July 30, 2015. A large Swedish study published on Wednesday, December 13, 2023, JAMA Psychiatry, discovered a paradox about people diagnosed with excessive fear of serious illness: They tended to die younger than those who were not overly vigilant about health problems.Credit: AP Photo/Bryn Anderson, File

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 depressed,” said Dr. Jonathan E. Alpert of Montefiore Medical Center. “But there are people at the other extreme who live with the fear of having a serious illness.” , in agony and contemplation.” in New York.

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

The study was published Wednesday in JAMA PsychiatryDavid Mataix-Cols of Sweden’s Karolinska Institute, who led the study, said it addressed “an apparent gap in the literature.” “We are lucky,” he said, because the Swedish disease classification system has a separate code for hypochondriasis, allowing analysis of data on thousands of people between 1997 and 2020.

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,” Mattex-Coles said. 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 measurement called “person-years,” which accounts for the number of people and how long they were tracked.

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.

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 be offended because they feel they are being accused of imagining symptoms.

“There needs to be a lot of respect and sensitivity conveyed to patients to let them know that this is a condition in itself and that it has a name,” Alpert said. “Fortunately, there are good treatments.”

More information:
David Mataix-Cols et al., All-cause and cause-specific mortality in hypochondriacal patients, JAMA Psychiatry (2023). DOI: 10.1001/jamappsychiatry.2023.4744

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citation: In the Depression Paradox, Swedish study finds higher mortality among those worried about serious illness (2023, December 13), Retrieved December 14, 2023 -12-hypochondria-paradox-swedish-higher-death.html

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