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Hypochondriasis, Somatization, and Perceived Health and Utilization of Health Care Services

Received August 21, 1998; revised February 1, 1999; accepted February 17, 1999. From the Departments of Psychiatry and Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico. Address correspondence and reprint requests to Dr. Hollifield, Departments of Psychiatry and Family and Community Medicine, University of New Mexico School of Medicine, 2400 Tucker Avenue, Albuquerque, NM 87131. *Dr. Kellner is deceased.

The authors determined the different effects of hypochondriasis and somatization on health perceptions, health status, and service utilization in a primary care population. The subjects with hypochondriacal responses (HR) on the Illness Attitudes Scales or high somatic concern (HSC) on the Symptom Questionnaire had a worse perception of health and variably used more health services than the control subjects, even though the HR and HSC subjects had the same level of chronic medical disorders. Regression analyses determined that somatization contributed more to negative health perception and service utilization than did hypochondriasis, although an interaction between the two contributed to the use of psychiatric care. The authors discuss the boundary between hypochondriasis and somatization for its implications for research and clinical practice.

Key Words: Hypochondriasis • Primary Care • Health Services • Somatization

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