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Overview: hypochondriasis, bodily complaints, and somatic styles

Published Online:https://doi.org/10.1176/ajp.140.3.273

Hypochondriasis can be conceptualized in four ways: 1) as a psychiatric syndrome composed of "functional" somatic symptoms, fear of disease, bodily preoccupation, and the persistent pursuit of medical care, 2) psychodynamically, as a derivative of aggressive or oral drives or as a defense against guilt or low self-esteem, 3) as a perceptual amplification of bodily sensations and their cognitive misinterpretation, and 4) as socially learned illness behavior eliciting interpersonal rewards. There is evidence supporting each of these views, but much more investigation is needed. The authors propose the general concept of somatic style--in particular, an amplifying style--which could be used to investigate symptom formation, bodily perception, and medical illness as a psychological and social event.

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