OBJECTIVE: This study examined the longitudinal course of patients known
to have had a previous episode of transient hypochondriasis. METHOD:
Twenty-two transiently hypochondriacal patients and 24 nonhypochondriacal
patients from the same general medical clinic were reexamined after an
average of 22 months with the use of self-report questionnaires, structured
diagnostic interviews, and medical record review. RESULTS: The
hypochondriacal patients continued to manifest significantly more
hypochondriacal symptoms, more somatization, and more psychopathological
symptoms at follow-up. They also reported significantly more amplification
of bodily sensations and more functional disability and utilized more
medical care. These differences persisted after control for differences in
medical morbidity and marital status. Only one hypochondriacal patient,
however, had a DSM- III-R diagnosis of hypochondriasis at follow-up.
Multivariate analyses revealed that the only significant predictors of
hypochondriacal symptoms at follow-up were hypochondriacal symptoms and the
tendency to amplify bodily sensations at the baseline evaluation.
CONCLUSIONS: Hypochondriacal symptoms appear to have some temporal
stability: patients who experienced hypochondriacal episodes at the
beginning of the study were significantly more hypochondriacal 2 years
later than comparison patients. They were not, however, any more likely to
develop DSM-III-R-defined hypochondriasis. Thus, hypochondriacal symptoms
may be distinct from the axis I disorder. The data are also compatible with
the hypothesis that preexisting amplification of bodily sensations is an
important predictor of subsequent hypochondriacal symptoms.