Hopp til hovedinnhold

Hypokondri

Sist revidert:
Sist revidert av:


Definisjon:
Overdreven helseangst eller sykdomsangst med vedvarende opptatthet av muligheten for å ha en eller flere alvorlige og fremadskridende somatiske lidelser
Forekomst:
I befolkningsstudier er forekomsten av hypokondri fra 0,7 til 3,4 %. I allmennpraksis er forekomsten vanligivs høyere
Symptomer:
Angstsymptomer som hjertebank, svimmelhet, kvalme og tretthet. Symptomene påvirkes av hvilken sykdom pasienten er opptatt av
Funn:
Kliniske funn er normale, med mindre pasienten har utviklet sin hypokondri sekundært til en kjent somatisk lidelse, f.eks. kreft, hvor legen mener det er god prognose, men pasienten likevel har en overdreven frykt for tilbakefall
Diagnostikk:
Man kan bruke et internasjonalt anerkjent selvutfyllingsskjema, f.eks. Whiteley Index. Ingen ytterligere undersøkelser har diagnostisk verdi
Behandling:
Behandlingen er samtaleterapi, medikamentell behandling (sjelden) eller en kombinasjon av disse
  1. 1Weck F. Richtberg S, Neng JMB. (2014) Epidemiology of Hypochondriasis and Health Anxiety: Comparison of Different Diagnostic Criteria. Current Psychiatry Reviews, 10, 14-23. doi:10.2174/1573400509666131119004444.
  2. Gureje O, Ustün TB, Simon GE. The syndrome of hypochondriasis: a cross-national study in primary care. Psychol Med. 1997 Sep;27(5):1001-10.PMID: 9300506. PubMed  
  3. Barsky AJ, Wyshak G, Klerman GL, Latham KS. The prevalence of hypochondriasis in medical outpatients. Soc Psychiatry Psychiatr Epidemiol. 1990 Mar;25(2):89-94.PMID: 2336583. PubMed  
  4. Fallon BA, Qureshi AI, Laje G, Klein B. Hypochondriasis and its relationship to obsessive-compulsive disorder. Psychiatr Clin North Am. 2000 Sep;23(3):605-16. PMID: 10986730. PubMed  
  5. Fallon BA, Harper KM, Landa A, et al. Personality disorders in hypochondriasis: prevalence and comparison with two anxiety disorders. Psychosomatics. 2012 Nov-Dec;53(6):566-74. Epub 2012 May 31. PMID: 22658329. PubMed  
  6. Noyes R Jr. The relationship of hypochondriasis to anxiety disorders. Gen Hosp Psychiatry. 1999 Jan-Feb;21(1):8-17. PMID: 10068915. PubMed  
  7. Furer P, Walker JR, Chartier MJ, Stein MB. Hypochondriacal concerns and somatization in panic disorder. Depress Anxiety. 1997;6(2):78-85. PMID: 9451549. PubMed  
  8. Warwick HM, Clark DM, Cobb AM, Salkovskis PM. A controlled trial of cognitive-behavioural treatment of hypochondriasis. Br J Psychiatry. 1996 Aug;169(2):189-95. PMID: 8871795. PubMed  
  9. Clark DM, Salkovskis PM, Hackmann A, et al. Two psychological treatments for hypochondriasis. A randomised controlled trial. Br J Psychiatry. 1998 Sep;173:218-25. PMID: 9926097. PubMed  
  10. Sørensen P, Birket-Smith M, Wattar U, et al. A randomized clinical trial of cognitive behavioural therapy versus short-term psychodynamic psychotherapy versus no intervention for patients with hypochondriasis. Psychol Med. 2011 Feb;41(2):431-41. Epub 2010 Apr 12. PMID: 20380779. PubMed  
  11. Tyrer P, Salkovskis P, Tyrer H, et al. Cognitive-behaviour therapy for health anxiety in medical patients (CHAMP): a randomised controlled trial with outcomes to 5 years. Health Technol Assess. 2017 Sep;21(50):1-58. PMID: 28877841. PubMed  
  12. Greeven A, van Balkom AJ, Visser S, et al. Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a randomized controlled trial. Am J Psychiatry. 2007 Jan;164(1):91-9. PMID: 17202549. PubMed  
  13. Axelsson E, Hedman-Lagerlöf E. Cognitive behavior therapy for health anxiety: systematic review and meta-analysis of clinical efficacy and health economic outcomes. Expert Rev Pharmacoecon Outcomes Res. 2019 Dec;19(6):663-676. Epub 2019 Dec 20. PMID: 31859542. PubMed  
  14. Hedman E, Andersson G, Andersson E, et al. Internet-based cognitive-behavioural therapy for severe health anxiety: randomised controlled trial. Br J Psychiatry. 2011 Mar;198(3):230-6. PMID: 21357882. PubMed  
  15. Axelsson E, Andersson E, Ljótsson B, et al. Effect of Internet vs Face-to-Face Cognitive Behavior Therapy for Health Anxiety: A Randomized Noninferiority Clinical Trial. JAMA Psychiatry. 2020 Sep 1;77(9):915-924. PMID: 32401286. PubMed  
  16. Veddegjærde KF, Sivertsen B, Skogen JC, Smith ORF, Wilhelmsen I. Long-term effect of cognitive-behavioural therapy in patients with Hypochondriacal Disorder. BJPsych Open. 2020 Apr 29;6(3):e42. doi: PMID: 32345417. PubMed  
  17. Eriksen HR, Ihlebaek C, Ursin H. A scoring system for subjective health complaints (SHC). Scand J Public Health. 1999 Mar;27(1):63-72. PMID: 10847674. PubMed  
  • Ingvard Wilhelmsen, spesialist i psykiatri og fordøyelsessykdommer, professor emeritus ved Universitetet i Bergen og driver Hypokonderklinikken ved Med. pol.kl Haraldsplass Diakonale Sykehus
  • Tor Andre Johannessen, lege og redaktør NEL (tilpasning til NEL)