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Hypochondriasis and Somatization Related to Personality and Attitudes Toward Self

Received August 21, 1998; revised October 22, 1998; accepted February 17, 1999. From the Departments of Psychiatry and Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM; Department of Psychiatry, Duke University, Durham, NC. 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.

Better definition of the boundary between hypochondriasis and somatization was determined by measuring attitudes to self and personality dimensions associated with these syndromes. In this study, the primary care patients with hypochondriacal responses (HR) on the Illness Attitudes Scales or high somatic concern (HSC) on the Symptom Questionnaire had more negative attitudes to self and more psychological distress than the matched group of primary care control subjects. The HR subjects were different from the non-HR subjects on two of five personality domains on the NEO Personality Inventory (NEO)-Five-Factor Inventory, and the HSC subjects were different from the non-HSC subjects on four of five NEO domains. Analysis of variance demonstrated that somatization explained most of the variance in attitudes, personality, and psychological distress, but hypochondriasis uniquely contributed only to thanatophobia. The authors discuss the boundary between hypochondriasis and somatization and offer a descriptive model of this relationship.

Key Words: Hypochondriasis • Somatization • Personality

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