Hypochondria Paradox

Once called hypochondriasis, it has now a new designation: illness anxiety disorder. It was added as a separate disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in 2013. It is a rare condition with symptoms that go beyond average health worries.

Symptoms include a ersistent anxiety or fear of developing or having a serious medical illness that adversely affects their daily life. This fear persists despite normal physical examination and laboratory testing results. Patients pay excessive attention to normal bodily sensations (such as functions of digestion or sweating) and misinterpret these sensations as indicators of severe disease[1]. Some may change doctors repeatedly. Others may avoid medical care.

Many of us are mild hypochondriacs. But there are also people on the other extreme of the spectrum who live in a perpetual state of worry and suffering and rumination about having a serious illness.

A large Swedish study has uncovered a paradox about people diagnosed with an excessive fear of serious illness: They tend to die earlier than people who aren’t hypervigilant about health concerns[2].

Older research had suggested the risk of suicide might be lower for people with the condition, but according to data in the new study, the risk of suicide was in fact four times higher for the people with the diagnosis.

Researchers looked at 4,100 people diagnosed with hypochondriasis and matched them with 41,000 people similar in age, sex and county of residence. They used a measurement called person years, which accounts for the number of people and how long they were tracked.

The researchers found that people with the diagnosis have an increased risk of death from both natural and unnatural causes, particularly suicide. Chronic stress and its impact on the body could explain some of the difference, the authors wrote.

The Hypochondria Paradox is therefore: The more you worry about dying early, the earlier you die.


[1] French, Hameed: Illness Anxiety Disorder in StatPearls – 2023. See here.
[2] David Mataix-Cols et al: All-Cause and Cause-Specific Mortality Among Individuals With Hypochondriasis in JAMA Psychiatry – 2023. See here.