Obsession with the body's functions and a DELUSION of ill health, often severe, such that patients may believe they have a brain tumour or incurable insanity. Furthermore, patients may believe that they have infected others, or that their children have inherited the condition. It is a characteristic feature of DEPRESSION, but may also occur in SCHIZOPHRENIA, when the delusions may be secondary to bodily HALLUCINATIONS and a sense of subjective change. Chronic hypochondriasis may be the result of an abnormal personality development: for example, the insecure, bodily-conscious person. Delusional preoccupations with the body – usually the face – may occur, such that the patient is convinced that his or her face is twisted, or disfigured with acne.
Hypochondriacal patients may also develop physical illness, and any new symptoms must always be carefully evaluated. In most patients the condition is secondary, and treatment should be directed to the underlying depression or schizophrenia. In the rare cases of primary hypochondriasis, counselling is the mainstay of treatment.