A 45 yrs old male came to the psychiatric OPD complaining of continuous, dull, non-progressive headache for the last 8 years. The patient has seen numerous neurologists in the belief that he has a brain tumor even though all his investigations have been normal. The patient insisted that he had a brain tumor and requested yet another workup. Psychiatric evaluation reveals disease conviction in the background of normal investigations. The most probable diagnosis is
Hypochondriasis:- This disorder is characterized by a preoccupation with the fear of having, or the idea that one has one or more serious physical illnesses. The preoccupation persists despite normal investigation results as well as doctors reassurances. It is impoant to differentiate hypochondriasis from somatization disorder. The emphasis in hypochondriasis is on the diagnosis whereas the emphasis in somatization disorder is on the symptoms. Also, hypochondriasis must be differentiated from delusional disorder (somatic type). In patients with hypochondriasis the belief is not as fixed as it is in delusional disorder. The patient with hypochondriasis may doubt his belief atleast for sho-term, after a normal investigation or medical reassurance. In contrast in delusional disorder, the belief is fixed and totally unshakeable. Ref:- Psychiatry by Sandeep Govil; pg num:-164
Somatization disorder
Somatoform pain disorder
Hypochondriasis
Conversion disorder
Somatoform disorders