A prospective 4- to 5-year study of DSM-III-R hypochondriasis.

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Abstract
LITTLE IS known about the natural history of hypochondriasis, although it is generally thought to be a chronic and stable condition with a relatively low spontaneous remission rate.1-10 More favorable outcomes are suspected in those without personality disorder, comorbid Axis I disorder, or accompanying stressful life events, and in those whose hypochondriasis is of shorter duration and accompanied by serious medical comorbidity.1-10 The empirical evidence for these impressions, however, is sparse and inconclusive. Recent studies have supplemented our understanding. Noyes et al11 conducted a prospective, case-controlled, follow-up of 48, DSM-III-R hypochondriacal patients. After 1 year, 67% (n=32) of the hypochondriacal patients still met diagnostic criteria for hypochondriasis, and these patients were significantly higher than the comparison group on measures of hypochondriacal symptoms, somatization, anxiety and depressive symptoms, and medical utilization. Improvement in hypochondriasis was predicted by a shorter duration of hypochondriasis at inception and fewer symptoms of depression and neuroticism. Robbins and Kirmayer12 conducted a prospective, 1-year follow-up of patients with hypochondriacal responses on an illness worry questionnaire. Hypochondriacal concerns declined significantly in one half, but they remained more concerned about their health at follow-up than nonhypochondriacal patients. Hypochondriasis was persistent in those with more medical comorbidity and more depressive and anxiety disorders.

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