The term hypochondriasis must be considered, in its historical, medical and sociological context, as a label misused extensively – often as an expression of the physician’s frustration, disappointment and anger when faced with an elusive diagnostic problem. Attempts at refinement of definition of terms such as hysteria, conversion reaction, somatization, psychophysiological and psychosomatic diseases are cited; yet the theoretical issues involved are often defiant of clarification and the problems in clinical differentiation remain complex. A case example of a ‘hypochondriacal patient’ illustrates the common clinical dilemmas experienced by patient, house staff and physicians, the iatrogenic components of dysfunctional doctor-patient relationships, and some of the psychodynamic mechanisms related to the patient’s mode of presentation, illness behavior, and ultimate disclosure of intrapsychic as well as psychosocial problems.

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© 1974 S. Karger AG, Basel
1974
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