Recognition of hypochondriasis in a clinic for sexually transmitted disease.

Abstract

A descriptive study of 100 consecutive patients referred for psychiatric assessment from a clinic for sexually transmitted disease (STD) is reported. Patients (36) presented with physical symptoms for which no organic cause was found. Various physical and psychological features of the overall presentation of this "somatic" group were identified. These are discussed in terms of diagnostic categories, etiological mechanisms and theories of illness behavior. The importance of directly observable aspects of the patients'' consultation behavior is stressed over and above deep psychological constructs. The diagnosis of hypochondriasis is essentially a medical one, which entails the doctor making a set of judgements that require a broad clinical perspective.