Hypochondriasis

Japanese: 心気症 - しんきしょう（英語表記）Hypochondriasis

What is the disease?

Long ago, in China Ki ( tree ) The people of this country thought that the sky was falling, and as they thought about it, they became anxious and were seized by a fear that lasted from night to day. Unfounded fears ( Qiu ) "It is called.

People are trivial Symptoms ( Choko ) People often fall into the trap of becoming anxious about something and being unable to break free from that belief due to their anxiety. When this anxiety manifests itself as an obsession with physical illness, it becomes hypochondria.

Based on the misconception that one may have some kind of disease, the doubt that one may be ill grows stronger, even though no abnormality or disease is found no matter how many tests one undergoes. Delusion ( Already so ) It's not that they refuse to accept interpretations from others, as in the above example. Rather, they visit hospital after hospital in search of a doctor's diagnosis and interpretation (doctor shopping), and even after undergoing tests, they are not convinced and often give doctors a hard time.

They are not satisfied with doctors who can assure them that everything is fine, but rather want doctors who can find illnesses. They are surprised and panicked when even the slightest suspicious finding is found or when a medical staff member suggests that they have an illness. They become increasingly afraid that they will eventually die from the illness.

This causes problems at work, and sometimes makes it impossible for them to come to work. Family members also seem to be exhausted from having to deal with the anxiety of patients.

What is the cause?

It may be caused by a past illness or a close relative's illness. Depression is often present, but even if depression improves after taking antidepressants, it may not necessarily improve.

Sometimes, there may be a private practitioner or a particular religious belief behind the patient that makes them believe they are ill. Also, the patient's complaints may be influenced by the society and culture in which they live.

Caution when making a diagnosis

For example, in the case of a former coal miner who is sensitive to polluted air and breathing difficulties, the most important thing to be aware of is not hypochondria, but the presence of a lung disease. A careless examination that misses a disease should not be attributed to hypochondria.

Elderly people often worry about their health, but their concerns are rational and they do not blindly go round to doctors looking for illnesses. Facial features ( Hard work ) If you have concerns about your body being ugly Body dysmorphic disorder ( Consumption tax ) This is a condition known as catastrophic morbidity and mortality, and in this case the patient's concerns are limited to their own appearance, rather than leading to fears of dying.

In rare cases, hypochondriacs do indeed develop the illness they feared and are told they have only a short time left to live. In my experience, I have been impressed by how the patient no longer worries unnecessarily and instead responds rationally to the reality of their illness.

Treatment methods

First, you should get a proper examination to see if there is really a physical illness. If the person's anxiety does not go away, it may be necessary to visit multiple reliable medical institutions.

Hypochondriasis often coexists with other mental disorders (depression, anxiety disorder, obsessive-compulsive disorder, delusional disorder, etc.). In such cases, treatment of the coexisting disorder may be effective, so it is necessary to visit a psychiatrist.

Yoshiharu Kane

Hypochondria
Hypochondria
Hypochondriasis
(Childhood illnesses)

What is the disease?

This is a state of excessive worry and anxiety about one's physical health. People often take minor physical abnormalities seriously and visit multiple medical institutions multiple times. This is a state that occurs as a result of overthinking things, even though there is no particular physical illness.

What is the cause?

The cause is unknown, but it is said that the individual's personality and living environment, including parent-child relationships, play a major role in the onset of the condition.

Triggers can also be changes in environment, such as changing schools or moving, or the illness or death of someone close to you, such as a grandparent.

How symptoms manifest

In adults, the most common symptom is "cancer neurosis," but in children, headaches ( Headache ( 100th Anniversary ) ), abdominal pain (abdominal discomfort), dizziness, floating sensation, general body Fatigue ( Health test ) They may complain of pain in their limbs, difficulty breathing, etc. This may result in them not attending school.

Testing and diagnosis

In addition to determining whether or not the child has a tendency to be neurotic, the circumstances of the onset, and other factors, a pediatrician will perform the necessary physical examinations and, if there are no physical illnesses, a diagnosis can be made. Many children become depressed secondarily, but it is important to distinguish between the two, as they may be accompanying symptoms of childhood depression.

Treatment methods

First, it is important to let the child rest both physically and mentally. Next, with the cooperation of the mother in particular, listen to any worries she may have and create an environment where the child can depend on the mother until the child regains strength. In some cases, small amounts of anti-anxiety medication or anti-depressants may be used. The prognosis is generally not bad.

What to do if you notice an illness

If anxiety or depression is severe, visit and treatment by a child psychiatrist will be necessary.

Hideo Matsumoto

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな病気か

　昔、中国の杞(き)の国の人は、空が落ちてくるのではないかと思い、そのことを思ううちに不安になって夜も日も明けぬ恐怖にとらわれたといいます。これを「杞憂(きゆう)」といいます。

　人は些細な兆候(ちょうこう)によって何かを不安に思い、不安のためにその思いこみから抜けられないという落とし穴に落ちることがしばしばあります。その不安が、体の病気へのとらわれという形で表れたものが心気症です。

　自分が何かの病気にかかっているのではないかという誤解に基づき、どんなに検査を行っても異常も病気も見つからないにもかかわらず、自分が病気ではないかという疑念はますます強くなります。しかし、妄想(もうそう)のように、人の解釈を受けつけないということはありません。むしろ医師の診断、解釈を求めて次々と病院を受診し（ドクターショッピング）、検査をしても納得せずに医師を手こずらせることが多いのです。

　大丈夫だと保証してくれる医師には満足せず、病気を見つけてくれる医師を求めます。少しでも疑わしい所見が見つかったり、医療スタッフの会話から病気が示唆された時には驚き、あわてます。病気の末に、死んでしまうのではないかという恐怖が強くなります。

　そのために仕事に支障が生じ、時には出勤不能となります。家族も、患者さんの不安に付き合わされ、疲れていることが多いようです。

原因は何か

　過去に実際にあった病気や、近親者の病気などが原因になっていることがあります。うつ病を合併していることが多いのですが、抗うつ薬を服用してうつ病が改善しても、必ずしもよくならない場合があります。

　時には、患者さんの背後に民間医療者や特定の宗教的な考えがあって、病気であるという考えを患者さんに与えている場合があります。また、患者さんの訴えは、その社会や患者さんが生きてきた文化に影響されていることもあります。

診断にあたっての注意

　たとえば過去に炭坑で働いていた人で、空気の汚れや呼吸困難に敏感な人の場合、最も注意すべきなのは心気症ではなく、肺の疾患があることです。粗雑な検査による病気の見逃しを、心気症のせいにしてはなりません。

　高齢者はしばしば自分の健康を心配しますが、その心配のしかたは合理的であり、やみくもに病気を探して医者を回るということはありません。また、自分の顔貌(がんぼう)や身体が醜いのではないかというとらわれがある場合は醜形恐怖(しゅうけいきょうふ)と呼ばれる状態であり、この場合は、患者さんの不安は自分の外観ということだけに限られているので、死んでしまうというような不安にはつながりません。

　ごくまれに、心気症の人が、心配していたとおりの病気になってしまい、余命いくばくもないと本当に宣告されてしまうことがあります。筆者の経験では、そのような場合、患者さんはもはや無用の心配をすることをやめ、現実の病気に合理的に対応したことが印象的でした。