Social Psychologic Factors Affecting the Presentation of Bodily Complaints

PATIENTS often recognize symptoms for which they seek medical assistance, but, on the basis of a history and physical and laboratory examination, the physician cannot obtain evidence to account for or justify the patients' complaints.1 Such patients conform in part to Gillespie's concept of hypochondria, which he viewed as "a persistent preoccupation with the bodily health, out of proportion to any existing justification and with a conviction of disease."2 There is considerable disagreement, however, on the appropriate formal definition of hypochondria,3 and it may be incorrect to apply the same designation to profound and persistent hypochondrical syndromes associated with psychiatric . . .