Functional Somatic Symptoms and Hypochondriasis: A Survey of Empirical Studies

doi:10.1001/archpsyc.1985.01790310089012

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Vol. 42 No. 8, August 1985

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Functional Somatic Symptoms and Hypochondriasis

A Survey of Empirical Studies

Robert Kellner, MD

Arch Gen Psychiatry. 1985;42(8):821-833.

Abstract

• Empirical studies suggest the following main conclusions:functional somatic symptoms are extremely common; a large proportionappear to be caused by physiologic activity and tend to be aggravatedby emotion. Hypochondriacal patients misunderstand the natureand significance of these symptoms and believe that they areevidence of serious disease. Hypochondriasis can be a part ofanother syndrome, usually an affective one, or it can be a primarydisorder. The prevalence differs between cultures and socialclasses. Constitutional factors, disease in the family in childhood,and previous disease predispose to hypochondriasis. Variousstressors can be precipitating events. Selective perceptionof symptoms, motivated by fear of disease, and subsequent increasein anxiety with more somatic symptoms appear to be links inthe vicious cycle of the hypochondriacal reaction. Psychotherapyas well as psychotropic drugs are effective in the treatmentof functional somatic symptoms. There are no adequate controlledstudies of psychotherapy in hypochondriasis, and the recommendedtreatments are based on studies with similar disorders. Theprognosis of treated hypochondriasis is good in a substantialproportion of patients.

Author Affiliations

From the Department of Psychiatry, School of Medicine, University of New Mexico, Albuquerque.

Footnotes

Accepted for publication May 17, 1984.

Reprint requests to 2400 Tucker, Albuquerque, NM 87131 (Dr Kellner).

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