A large Swedish study has uncovered a peculiar paradox regarding individuals diagnosed with an excessive fear of serious illness, also known as hypochondriasis or illness anxiety disorder. Surprisingly, these individuals tend to die earlier than those who are not hypervigilant about health concerns, according to the study published in JAMA Psychiatry.

The study, led by David Mataix-Cols of the Karolinska Institute in Sweden, addressed the gap in literature by analyzing data on thousands of people over a span of 24 years, from 1997 to 2020. The Swedish classification system for diseases proved advantageous in this research as it has a separate code for hypochondriasis, allowing for accurate data analysis.

Hypochondriasis goes beyond average health worries, with individuals unable to alleviate their fears even after normal physical exams and lab tests. Some may resort to repeatedly changing doctors, while others may avoid seeking medical care altogether. "Many of us are mild hypochondriacs. But there are also people on the other extreme of the spectrum who live in a perpetual state of worry and suffering and rumination about having a serious illness," explains Dr. Jonathan E. Alpert of Montefiore Medical Center in New York, who was not involved in the study.

The researchers found that people diagnosed with hypochondriasis have an increased risk of death from both natural and unnatural causes, particularly suicide. The authors speculate that chronic stress may contribute to this elevated risk of mortality.

In the study, 4,100 individuals diagnosed with hypochondriasis were compared to a control group of 41,000 people of similar age, sex, and residence. The analysis took into account person years, a measurement that considers the number of people and the duration of the study. The overall death rates were higher for those with hypochondriasis, with 8.5 deaths per 1,000 person years compared to 5.5 deaths per 1,000 person years in the control group. Additionally, individuals with hypochondriasis died at a younger age, with an average age of 70 compared to 75 in the control group. Furthermore, the risk of death from circulatory and respiratory diseases was higher for those with hypochondriasis, although the risk of death from cancer was similar between the two groups.

The study highlights the need to take hypochondriasis or illness anxiety disorder seriously and provide appropriate treatment. Treatment options can include cognitive behavioral therapy, relaxation techniques, education, and sometimes antidepressant medication.

Although previous research suggested a lower risk of suicide for individuals with hypochondriasis, the new study contradicts this finding. The risk of suicide death was found to be four times higher among those diagnosed with hypochondriasis.

Referring excessively anxious patients to mental health professionals must be done with care and sensitivity to avoid offending them. Dr. Alpert, who leads the American Psychiatric Association's council on research, stresses the importance of conveying to patients that hypochondriasis is a legitimate condition that can be treated effectively.

In conclusion, this Swedish study sheds light on the paradoxical relationship between excessive fear of serious illness and earlier death. By acknowledging the severity of hypochondriasis and offering proper treatment, it is possible to improve outcomes for these individuals and potentially reduce their risk of premature death.