When a hypochondriasis forced a patient to emigrate

Abstract

Introduction

Illness anxiety disorder, or hypochondriasis, is one the most difficult and complex psychiatric disorders to treat.

Objectives

To describe a case of a patient with illness anxiety disorder and summarize the most important aspects on this theme.

Methods

Interviews with the patient and literature review searching the PubMed/MEDLINE were performed.

Results

A 42-year-old married man, dentist, Angolan citizen, who had recently arrived in Portugal, was referred to psychiatry assessment during his hospitalization in medicine service, after an exhaustive medical evaluation. He was excessively anxious and worried about having a severe heart disease because he has gradually become more aware of palpitations and chest pain. Although negative results of the examinations he was worried that “something has been missed”. After he had consulted several medical providers in Luanda, he decided to seek medical advice in Portugal. Patient believed that his symptoms exacerbated with activity and intake food, so he gradually restricted them. Due to his health anxiety, he stopped his work and lost 36 kilos. Shortly before the onset of the clinical picture, his daughter was hospitalized for the first time.

Conclusion

Illness anxiety disorder often begins in early to middle adulthood. Its core feature is the fear or idea of having a serious disease, based on the misinterpretation of bodily signs and sensations as evidence of disease, which persists despite appropriate medical evaluations and reassurance. This patient fulfills the DSM-5 criteria of Illness anxiety disorder and has a clinical profile similar to those found in literature.

Disclosure of interest

The authors have not supplied their declaration of competing interest.