Hypochondriacs have a higher risk of death

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Hypochondriac people have an increased risk of dying from natural or unnatural causes, particularly suicide.

Associated Press

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A large Swedish study has uncovered a paradox regarding people diagnosed with excessive fear of serious illnesses: they tend to to die earlier than people who are not hypervigilant when it comes to health.

Hypochondria, now called illness anxiety disorder, is a rare condition whose symptoms go beyond average health-related concerns.

People with this disorder are unable to allay their fears despite normal physical exams and laboratory tests. Some may change doctors several times. Others avoid medical care.

Many of us are mild hypochondriacs. But there are also people at the other end of the spectrum who live in a perpetual state of worry, suffering and rumination about a serious illness, explained Dr. Jonathan E. Alpert of Montefiore Medical Center in New York, who was not involved in the new study published in JAMA Psychiatry (New window) (in English).

People with this disorder suffer and it is important to take it seriously and treat it, Dr. Alpert added. Treatment may include cognitive behavioral therapy, relaxation techniques, education and sometimes antidepressants.

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Researchers have found that people with hypochondriasis have an increased risk of dying from natural or unnatural causes, particularly suicide. Chronic stress and its impact on the body could partly explain this difference, write the authors.

The study fills an obvious gap in the literature, said David Mataix-Cols of the Karolinska Institute in Sweden, who led the research .

We were lucky, he said, because the Swedish disease classification system has a separate code for hypochondriasis, which made it possible to analyze data from thousands of people over a 24-year period (1997-2020).

Previous research has suggested that the risk of suicide may be lower in people with this condition , but our intuition, based on clinical experience, was that this would be incorrect, said Mr. Mataix-Cols. In the study, the risk of suicide was four times higher among people who received this diagnosis.

Researchers looked at 4,100 people who had been diagnosed with hypochondriasis and compared them to 41,000 people similar in age, gender and county of residence. They used a metric called person-years, which takes into account the number of people and how long they were followed.

The overall mortality rate was higher among people with hypochondriasis, 8.5 versus 5.5 per 1,000 person-years. People with hypochondria died younger than others, at an average age of 70 versus 75. Their risk of death from circulatory and respiratory diseases was higher. Cancer was an exception: the risk of death was about the same.

Referring an excessively anxious patient to professionals mental health requires caution, said Dr. Alpert, who heads the research council of the American Psychiatric Association. Patients may be offended because they feel like they are being accused of imagining their symptoms.

It takes a lot of respect and sensitivity to make patients understand that it is a kind of illness, that it has a name, explained Doctor Alpert. Fortunately, there are good treatments.