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DSM-IV & DSM-IV-TR: Hypochondriasis


When a patient remains preoccupied with the fear that they have a serious medical illness despite the fact that medical evaluation has ruled out such an illness, this Somatoform Disorder can be diagnosed. Although the belief is not of delusional intensity, attempts at reassurance fail.

Diagnostic criteria for 300.7 Hypochondriasis
(cautionary statement)
 

A. Preoccupation with fears of having, or the idea that one has, a serious disease based on the person's misinterpretation of bodily symptoms

B. The preoccupation persists despite appropriate medical evaluation and reassurance. 

C. The belief in Criterion A is not of delusional intensity (as in Delusional Disorder, Somatic Type) and is not restricted to a circumscribed concern about appearance (as in Body Dysmorphic Disorder). 

D. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

E. The duration of the disturbance is at least 6 months. 

F. The preoccupation is not better accounted for by Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, a Major Depressive Episode, Separation Anxiety, or another Somatoform Disorder

Specify if: 
With Poor Insight: if, for most of the time during the current episode, the person does not recognize that the concern about having a serious illness is excessive or unreasonable

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American Psychiatric Association

Also: hypochondria, hypochondriac

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