These symptoms take many forms. The most important feature is undue preoccupation with physical ill health despite well-founded reassurance.
Two thirds of the patients complain of pain. Common sites include the head, lower lumbar region, and the right iliac fossa. Descriptions of the pain are usually imprecise and the pain is said to occur in a diffuse area of the body.
Gastrointestinal symptoms are often present, including nausea, dysphagia, biliousness, regurgitation of acid, flatulence and abdominal pain.
Cardiovascular complaints include palpitations, left-sided chest pain, difficulty in breathing, worries about high blood pressure.
Other possible symptoms that might be present include worry about bladder function; complaints about appearance eg the shape of nose, ears or breasts; body odour and sweating.
Barsky and Klermen (Overview: Hypochondriasis, Bodily Complaints and Somatic Styles; American Journal of Psychiatry 1983) stated four characteristics of the hypochondriacal patient:- - patients are more concerned with the authenticity, meaning, and aetiological significance of their symptoms than they are with the unpleasant physical sensations per se. - patients have an urgent fear of disease and the profound conviction that they are sick. - patients are absorbed in their suffering, their bodily sensations, and their physiological functions. - patients relentlessly and tenaciously seek medical care, solicit procedures and diagnostic tests, and have extensive histories of previous medical care.
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