Being overly worried about getting sick may, actually, help send you to an early grave, new research out this month suggests. The study found that people diagnosed with hypochondriasis were noticeably more likely to die during the study period than those without it. An increased risk was seen across both natural and unnatural causes of death but was especially large for suicide.
Hypochondriasis—previously called hypochondria and now also known as illness anxiety disorder—is defined as a persistent and unrealistic fear of severe illness. People with hypochondriasis will continue to worry about being or becoming sick even after receiving tests and physical exams that appear to show a lack of any disease, and this preoccupation can severely impair their daily lives and relationships with others. The condition is similar to somatic symptom disorder, though people with the latter will experience extreme anxiety about concrete physical symptoms such as pain.
Hypochondriasis is considered rare, perhaps affecting less than 1% of the general population, though it might be very underdiagnosed. And the authors of a new study, published this month in JAMA Psychiatry, say that little is known about the mortality risk associated with the condition.
To better understand this risk, the authors looked at nationwide medical record data from Sweden, which has long maintained a separate classification code for cases of diagnosed hypochondriasis. From 1997 to 2020, the team identified over 4,000 cases of the disorder. They then compared the health outcomes of these patients to about 40,000 control patients matched in age and other demographics.
During the study period, people with hypochondriasis were significantly more likely to die from any cause than people without hypochondriasis (a death rate of 8.5 versus 5.5 per every 1,000 person years). The increased risk was seen in hypochondriacs even after adjusting for other variables, and could be seen across many causes of death, particularly suicide. People with hypochondriasis were over four times more likely to die from suicide, and the majority of unnatural deaths in this group were tied to suicide.
The findings not only shine a light on the mortality risk of hypochondriacs, but might dispel the perception that they’re better at staving off death than others as a result of seeing their doctors more often.
“Superficially, one might think that because they frequently consult with doctors, individuals with hypochondriasis may have lower risk of death,” study author David Mataix-Cols, a researcher at the Karolinska Institute in Stockholm told Medpage Today. “However, clinicians working with this patient group know that many individuals experience considerable suffering and hopelessness, which could explain the elevated risk of suicide we describe in the paper.”
The authors note that most of the deaths seen in the study would be considered preventable. And there are potential treatments available for hypochondriasis, such as cognitive behavioral therapy or antidepressant medication. But doctors who come across suspected cases of hypochondriasis should also take care to not stigmatize those suffering from it and related conditions, the authors say.
“Dismissing these individuals’ somatic symptoms as imaginary may have dire consequences,” they wrote. “More should be done to reduce stigma and improve detection, diagnosis, and appropriate integrated (ie, psychiatric and somatic) care for these individuals.”