Transient and persistent hypochondriacal worry in primary care

Abstract

SynopsisWe 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.