Somatoform Disorders

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Hypochondriasis

It is

a disorder characterized by a persistent preoccupation of fear of contracting a disease or the belief of having a serious disorder. Patients with hypochondriases have unrealistic or inaccurate interpretations of physical symptoms in the absence
of any known medical disorder. It causes significant distress or impairment in functioning.

Epidemiology: Men and women are equally affected. It is most commonly

seen in people who are between 20 and 30 years of age.

Etiology

  • Perceptual eg. perception of abdominal pressure as abdominal pain.

  • Cognitive : Misinterpretation of bodily sensations

  • Emotional : These symptoms are an expression of anger or guilt. Anxiety and depression are found to coexist with hypochondriasis.

  • Behavioral : The symptoms are to play a sick role which helps them to escape from obligations, postpone unwelcome challenges etc.

Clinical features: Patients with hypochondriasis maintain a belief that they have a particular disease inspite of negative laboratory results, benign course of the disease and reassurances by physicians.

Differential Diagnosis : Must be differentiated from AIDs, endocrinopathies, occult neo

Table - 1 Clinical features of converson disorder.

Sensory symptoms Anaesthesia, paresthesia, deafness, blindness,tunnel vision.

Motor symptoms Abnormal movements, gait disturbances, weakness, paralysis, tremors, ticks jerks etc.

Seizure symptoms It is one of the more common symptoms in conver- siondisorder.

plastic disorders, degenerative disorders of the nervous system, other somatoform disorders and malingering.

Course: Episodic. Exacerbations of hypochondriacal symptoms are associated with psychosocial stressors.

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