Department of Psychiatry, Columbia University, New York, NY 10032, USA.
Psychosomatics. 2012 Nov-Dec;53(6):566-74. doi: 10.1016/j.psym.2012.02.002. Epub 2012 May 31.
Symptoms of hypochondriasis are sometimes attributed to personality psychopathology by health care providers. The goals of this study were to assess the prevalence of personality disorder (PD) comorbidity in hypochondriasis (HYP) and to compare the PD comorbidity profile of patients with HYP with that found among patients with other disorders characterized by intrusive thoughts and fears.
Structured Clinical Interview for DSM-IV Axis I and Axis II Disorders (SCID-I and SCID-II) were administered to 179 individuals: 62 with HYP, 46 with obsessive-compulsive disorder (OCD), and 71 with social anxiety disorder (SAD). For group contrasts, the samples were "purified" of the comparison comorbid disorders. General linear models were used to test the combined effect of group (HYP, OCD, SAD), age, and gender on the PD outcome variables.
59.7% of HYP subjects had no Axis II comorbidity. The most common PDs in HYP were paranoid (19.4%), avoidant (17.7%), and obsessive-compulsive (14.5%). HYP significantly differed from SAD in the likelihood of a cluster C disorder, whereas no significant difference was noted for HYP vs. OCD. The proportion of subjects having at least two PDs was not significantly different for HYP vs. OCD or for HYP vs. SAD.
Although 40% of patients with hypochondriasis have PD comorbidity as assessed by the SCID-II, the amount of PD comorbidity is not significantly different than found among individuals with two comparison anxiety disorders. Therefore, health providers should be aware that PD may complicate the clinical profile of HYP, but they should avoid assuming that PD psychopathology is the primary source of hypochondriacal distress.
健康护理提供者有时将疑病症的症状归因于人格精神病理学。本研究的目的是评估疑病症（HYP）中人格障碍（PD）共病的患病率，并比较 HYP 患者与其他以侵入性思维和恐惧为特征的障碍患者的 PD 共病特征。
对 179 名个体进行了 DSM-IV 轴 I 和轴 II 障碍的结构性临床访谈（SCID-I 和 SCID-II）：62 名 HYP 患者、46 名强迫症（OCD）患者和 71 名社交焦虑症（SAD）患者。为了进行组间比较，对样本进行了“净化”，去除了比较共病障碍。使用一般线性模型来检验组（HYP、OCD、SAD）、年龄和性别对 PD 结果变量的综合影响。
59.7%的 HYP 患者没有轴 II 共病。HYP 中最常见的 PD 是偏执型（19.4%）、回避型（17.7%）和强迫型（14.5%）。HYP 与 SAD 在集群 C 障碍的可能性上显著不同，而 HYP 与 OCD 之间则没有显著差异。HYP 与 OCD 或 HYP 与 SAD 相比，至少有两种 PD 的患者比例没有显著差异。
尽管 40%的疑病症患者通过 SCID-II 评估存在 PD 共病，但 PD 共病的程度与两种比较焦虑障碍患者没有显著差异。因此，健康护理提供者应该意识到 PD 可能会使 HYP 的临床特征复杂化，但他们应该避免假设 PD 精神病理学是疑病症痛苦的主要来源。
