The Boundary Between Hypochondriasis and Obsessive-Compulsive Disorder: A Cross-Sectional Study From the Netherlands
J Clin Psychiatry 2006;67:1682-1689
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: To investigate similarities and
differences between the symptom profiles of patients with hypochondriasis and those of
patients with obsessive-compulsive disorder (OCD) and
to compare the contamination/cleaning OCD subtype to other OCD subtypes.
Method: Between January 1998 and
July 2002, 76 patients diagnosed with
hypochondriasis (N = 31) or OCD (N = 45) (DSM-IV criteria)
and 25 subjects with no formal DSM-IV diagnosis were compared with regard to the extent of
diagnosis-specific symptoms, the number and nature of physical symptoms, and whether these
symptoms evoked fear. The analyses were repeated after subdividing the OCD patients into the
contamination/cleaning and other OCD subgroups.
Results: Patients with hypochondriasis
and OCD differed significantly from each other on
the extent of diagnosis-specific symptoms (all p
< .001). Patients with hypochondriasis reported significantly more obsessive-compulsive
symptoms and patients with OCD reported significantly more hypochondriacal symptoms than
did the healthy control-group members (all p <
.05). Neither group differed significantly from
the other on the number and nature of feared
physical symptoms. The contamination/cleaning OCD
subtype did not differ significantly from other
OCD subtypes in either the severity of
hypochondriacal symptoms or the number of feared
Conclusion: Hypochondriasis and OCD
can be distinguished on the basis of
diagnosis-specific symptoms, although they share a number of
similarities. In addition, although patients with
the contamination/cleaning OCD subtype tend to be afraid of contracting diseases, the differences
between the symptom profiles of these patients and those of patients with hypochondriasis exceed
the similarities. Our results confirm that the 2
conditions are separable and valid diagnoses.