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Childhood Antecedents of Hypochondriasis

Received December 14, 2001; accepted December 28, 2001. From the Departments of Biostatistics and Psychiatry, University of Iowa Colleges of Medicine and Public Health, Iowa City, Iowa. Address correspondence and reprint requests to Dr. Noyes, Psychiatry Research, Medical Education Building, Iowa City, IA 52242; russell-noyes{at}uiowa.edu (e-mail).

According to the interpersonal model of hypochondriasis, early environmental adversity may give rise to attachment insecurity that finds adult expression in care-seeking behavior. To identify antecedents of this disturbance, we interviewed general medicine patients and obtained from them self-reports of traumatic events, adverse circumstances, and symptoms experienced in childhood. Patients who met DSM-III-R criteria for hypochondriasis more often reported traumatic events and circumstances, including serious illness or injury. Among all patients, the level of hypochondriacal symptoms in adulthood was correlated with poor health, hypochondriacal worry, and separation anxiety in childhood. These findings are consistent with a growing literature that links childhood adversity to adult hypochondriasis; they support the interpersonal model.

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