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Transient and persistent hypochondriacal worry in primary care

Published online by Cambridge University Press:  09 July 2009

James M. Robbins  and
Laurence J. Kirmayer
James M. Robbins*
Affiliation:
Departments of Pediatrics and Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA; Institute of Community and Family Psychiatry, Sir Mortimer B. Davis-Jewish General Hospital and Department of Psychiatry, McGill University, Montreal, Quebec, Canada
Laurence J. Kirmayer
Affiliation:
Departments of Pediatrics and Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA; Institute of Community and Family Psychiatry, Sir Mortimer B. Davis-Jewish General Hospital and Department of Psychiatry, McGill University, Montreal, Quebec, Canada
*
1Address for correspondence: Dr James M. Robbins, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital., 800 Marshall Street, Little Rock, Arkansas 72202., USA.
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Synopsis

We present a 12-month prospective study of hypochondriacal worry in primary care. Data were obtained from 546 family medicine patients at the time of a physician visit for a new illness and again 1 year later. Patients were divided into four groups based on scores on the Illness Worry Scale: non-hypochondriacal (N = 460), transient hypochondriacal (N = 34); emerging hypochondriacal (N = 21); and persistent hypochondriacal (N = 31). Persistent patients had significantly more serious medical history but no more serious current illness than those low on illness worry. Patients with persistent illness worry were more likely than others to have a diagnosis of major depression or anxiety disorder, were more likely to believe that their most important significant other would pathologize new symptoms, yet were less likely to have been encouraged to see the doctor by them. Patients who became less worried over the year reported corresponding decreases in distress, attentiveness to bodily sensations, emotional vulnerability and pathological symptom attributions. We conclude that depressive or anxiety disorders, fears of emotional instability, pathological symptom attributional styles and interpersonal vulnerability provide the best prognostic evidence for enduring illness worry.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 3 , May 1996 , pp. 575 - 589
Copyright
Copyright © Cambridge University Press 1996

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