Stephen Hughes – The Conversation
Hypochondriac people who worry excessively about their health tend to die earlier than those who don’t, according to a recent study conducted in Sweden.
It seems strange that hypochondriacs who, by definition, worry but are not actually sick, enjoy a shorter life expectancy than the rest of us, right?
Before delving into the reasons, it is worth stopping at the terminology. Since the term hypochondriac is becoming something pejorative, medical professionals prefer to talk about illness anxiety disorder.
We can define it as a mental health disorder characterized by excessive concern about health, often with the unfounded belief that a serious illness exists.
Sometimes it is associated with frequent visits to the doctor, while other times it involves avoiding them altogether for fear of being diagnosed with a fatal illness.
He illness anxiety disorder It causes the affected person to spend excessive time worrying and visiting clinics and hospitals. In addition to stigmatizing those who suffer from it, it is quite costly for health systems, due to the time and diagnostic resources it consumes uselessly.
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As for health professionals, usually overworked, they would prefer to dedicate their time to treating people with “real diseases.” That is why it is not unusual for them to have contemptuous behavior when receiving these patients.
Suicide cases increase
A team of Swedish researchers tracked about 42,000 people – of whom 1,000 suffered from illness anxiety – over two decades. During that period, they found that people with the disorder had a higher risk of death. Furthermore, the risk of death increased from both natural and unnatural causes.
How are these curious results explained? Does it mean that, perhaps, something bad does happen to people with hypochondria?
Analyzing the results in greater depth, the researchers detected that people who died of natural causes had increased mortality from cardiovascular causes, respiratory and unknown. Curiously, they did not show an increase in cancer mortality, despite the fact that anxiety about cancer is widespread in this population.
On the other hand, the main cause of unnatural death in the illness anxiety disorder cohort was suicide, with an increase of at least four times compared to the rest of the subjects.
More disorders, depression, addictions and suicide
This disorder is known to be closely related to psychiatric disorders. Given that the risk of suicide increases with psychiatric illnesses, this finding seems quite reasonable. Add to the fact that people with hypochondria can feel stigmatized and disregarded, and it follows that this can contribute to anxiety and depression, which in some cases ultimately leads to suicide.
The increased risk of death from natural causes seems less easy to explain. There may be lifestyle factors. Without going any further, the consumption of alcohol, tobacco and drugs is more common in anxious people and those who suffer from a psychiatric disorder. Given the These addictions can limit longevityperhaps its presence explains, in part, the increase in mortality due to illness anxiety disorder.
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We also know that this problem is more common in those who have had a family member with a serious illness. Considering that many serious diseases have a genetic component, it could be that life expectancy is shortened by “defective” genes.
What can we learn?
Health care professionals should be alert to possible underlying health problems in apparently hypochondriacal patients and listen to them more carefully. When we look down on our patients, we can often come off badly.
At this point, the case of the French novelist Marcel Proust can serve as an example. His biographers often describe Proust as a hypochondriac, although he died in 1922 at the age of 51, when the life expectancy of a Frenchman at that time was 63 years.
Throughout his life, he reported suffering numerous gastrointestinal symptoms, such as a feeling of fullness, bloating, and vomiting. But the doctors who treated him found nothing.
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However, what you described is consistent with gastroparesis. This is a disorder in which the motility of the stomach is reduced, which empties more slowly than it should and becomes overfilled. This can cause vomiting and with it the risk of inhaling the vomit, leading to aspiration pneumonia. Well, it is precisely known that Proust died from complications of pneumonia. Chance?
Finally, a warning: writing about this disorder can be quite risky. The French playwright Molière wrote The Malade Imaginaire (The imaginary invalid), a play about a hypochondriac named Argan who tries to get his daughter to marry a doctor to reduce his medical bills. Molière died in the fourth performance of his work. If he makes fun of hypochondriacs, do so at your own peril.
Stephen Hughes He is a professor of Medicine at the British university Anglia Ruskin University.
