Transient Hypochondriasis: A New Somatoform Diagnosis?
Arthur J. Barsky, MD
Psychiatry Service Massachusetts General Hospital Department of Psychiatry Harvard Medical School Fruit St Boston, MA 02114
Grace Wyshak, PhD
Center for Population Studies Harvard School of Public Health 9 Bow St Cambridge, MA 02138
Gerald L. Klerman, MD
Department of Psychiatry Cornell University Medical College 525 E 68th St New York, NY 10021
Arch Gen Psychiatry. 1991;48(10):955-956.
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In Reply.—
Dr Yates' thoughtful comments deserve serious consideration and future investigation.
His basic point is key: parsimony dictates that before constructing new diagnoses we first attempt to fit new observations into the existing taxonomy. Specifically, he suggests that transient hypochondriasis might best be conceptualized not as a somatoform disorder but as an adjustment disorder, one in which the individual responds to the stress of major medical illness with "functional" physical symptoms and excessive concerns about illness. Because DSM-III-R already describes adjustment disorder with physical complaints (309.82), Yates suggests we broaden this diagnosis to include hypochondriacal disease fears, disease conviction, and bodily preoccupation, as well as somatic complaints that are not medically explainable. Such a proposal raises two questions: (1) Are transient hypochondriacal states better thought of as adjustment disorders or as somatoform disorders? (2) Is there a significant difference between transient somatization and transient hypochondriasis—ie, between responding to stress with
. . . [Full Text PDF of this Article]
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