Ipohondrie

How can patients be "cured" when they continue to believe they are seriously ill despite all
medical reassurances and other evidence to the contrary? It's a question that has long stymied
doctors who treat the one in 20 Americans with hypochondria.
-therapy is effective because it aims at the basic problem -- the way these patients think about
their symptoms," researcher Arthur J. Barsky, MD, tells WebMD. "They tend to think that
anything that bothers them has a medical explanation, when it in fact, that is not always
true. Lower back pain is a perfect example. It can be severe but don't always have a medical
explanation."
Hypochondriacs are preoccupied with their physical health and have an unrealistic fear of
serious disease that is not in proportion to the actual risk. While they actually feel "real"
symptoms, they may assume it's life-threatening -- and continue this belief for at least six
months after being "cleared" in a medical evaluation.
-are not reassured by doctors after they've done tests and determined they do not have a
serious illness."
-may result from childhood events, such as when a parent gets sick or dies
-By changing the way they think, it helps them to understand their symptoms in a different way,
and not be as frightened by them,
When their fear and anxiety associated with symptoms subsides, the symptoms themselves
tend to subside because the nervous system quiets down.
SCOP: significantly lower levels of hypochondriacal symptoms, beliefs, and attitudes and
health-related anxiety
http://www.psychiatrictimes.com/articles/hypochondriasis-fresh-outlook-treatment
it is the meaning of the physical sensation rather than the sensation itself. For example, the hypochondriac who
complains about headaches is more concerned with the "tumor" that is "causing" the headache than the headache
pain itself.
Although some findings are contradictory, hypochondriasis usually occurs between the ages of 36 to 57, and it is
believed to occur more frequently in females than in males. Estimates of the prevalence of HC range from 4% to 20%
of the general population.
he basis of cognitive and behavior therapy lies in the assumption that patients with HC magnify
somatosensory cues, believe them to be dangerous and at the same time perceive themselves as incapable
of coping with the perceived threat. They also equate good health with being relatively symptom-free and
consider symptoms to be equal to sickness. Thus, an inadequate concept of health may contribute to a
perceptual and cognitive style of somatosensory amplification.

Cognitive and behavior therapy is based on two goals: challenging the faulty assumptions and preventing
avoidance behaviors
the clinician reviews the physical evidence for the complaints, identifies testable alternative explanations for the
symptoms and discovers automatic faulty assumptions. Examples of these would be: "I cannot tolerate the pain," "Any
physical symptom is a sign of danger" or "If I don't seek immediate help something catastrophic will happen." Once
articulated by the patient, the assumptions are then challenged.
In the behavioral component of the treatment, patients are asked to refrain from activities such as seeking
reassurance, checking their bodies for evidence of illness, or either reading or avoiding reading about their "illness."
The treatment is very similar to that given to patients with OCD, specifically exposure and response prevention with
cognitive therapy.