Abstract
Background: Given that on the one side considerable similarities between hypochondriasis and obsessive- compulsive disorder (OCD) by means of sharing a number of features, including intrusive thoughts and repeated checking (Barsky, 1992), on the other side similar structural neuroimaging data that found hypochondriac patients to have significantly smaller mean left and right OFC, and greater left thalamus volumes compared to those of healthy controls. Aims: We considered to investigate the hippocampal neurochemicals, found changed in OCD patients, in hypochondriac patients. Methods: Fifteen patients with hypochondriasis, recruited from our out- or in-patient clinics, were compared with 15 healthy control comparisons in regard to proton magnetic resonance spectroscopy (1H-MRS) imaging of hippocampus. Results: The patients with hypochondriasis had lower right and left NAA/CHO, and NAA/CRE, and near-significant lower right CHO/CRE hippocampal ratios than healthy matched comparison subjects. Conclusion: The data of the present investigation in patients with hypochondriasis provide preliminary evidence of lower right and left NAA/CHO, and NAA/CRE, near-significant lower right CHO/CRE hippocampal ratios, revealing neurochemical alterations in hippocampus and a further support the notion that hypochondriasis shares a variety of neurobiological similarities with OCD.
Highlights
Hypochondriasis, a somatoform disorder according to Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV), preoccupation with fears of having, or the idea that one has, a serious disease based on the person’s misinterpretation of bodily symptoms despite repetitive medical evaluation and reassurance
Given that on the one side considerable similarities between hypochondriasis and obsessivecompulsive disorder (OCD) by means of sharing a number of features, including intrusive thoughts and repeated checking [3], on the other side similar structural neuroimaging data that found hypochondriac patients to have significantly smaller mean left and right orbito-frontal cortex (OFC), and greater left thalamus volumes compared to those of healthy controls, we considered to investigate the hippocampal neurochemicals in hypochondriac patients
Our finding of lower NAA values in the patients with hypochondriasis, as supported by lower right and left NAA/CHO, and NAA/CRE ratios, compared to those in healthy comparison subjects supports the possibility that the hippocampal neuronal density or at least neuronal function in patients with hypochondriasis might have been affected
Summary
Hypochondriasis, a somatoform disorder according to Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV), preoccupation with fears of having, or the idea that one has, a serious disease based on the person’s misinterpretation of bodily symptoms despite repetitive medical evaluation and reassurance. In the etiology of hypochondriasis, psychosocial factors psychodynamic explanations have been always leaded until last years Even though they are limited, investigations have been started to account for neurobiological basis of hypochondriasis. Given that on the one side considerable similarities between hypochondriasis and obsessivecompulsive disorder (OCD) by means of sharing a number of features, including intrusive thoughts and repeated checking (Barsky, 1992), on the other side similar structural neuroimaging data that found hypochondriac patients to have significantly smaller mean left and right OFC, and greater left thalamus volumes compared to those of healthy controls. Conclusion: The data of the present investigation in patients with hypochondriasis provide preliminary evidence of lower right and left NAA/CHO, and NAA/CRE, nearsignificant lower right CHO/CRE hippocampal ratios, revealing neurochemical alterations in hippocampus and a further support the notion that hypochondriasis shares a variety of neurobiological similarities with OCD
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