To the Editor.
—The recent article by Dr Kellner1 entitled "Hypochondriasis and Somatization" was extremely informative yet also contained several controversial and unwarranted conclusions. Part of the confusion about these disorders relates to terminology. The 1980 DSM-III attempted to bring order out of the chaos by describing four types of somatiform disorders: (1) hypochondriasis, (2) somatization disorder, (3) conversion disorder, and (4) psychogenic pain disorder. I do not believe that this arbitrary separation is correct, nor does it truly represent and reflect the patient population. The term hypochondriacal should be reserved for those individuals who constantly play a sick role by misinterpreting normal physiological sensations as reflecting disease. Thus, constant preoccupation with specific disease or body systems, ie, cardiac phobia and cancerophobia, is the rule. The remainder of this group with chronic complaints represent disorders of the voluntary motor and sensory nervous system (hysterical conversion reaction) or of the
Weintraub MI. Hypochondriasis and Somatization. JAMA. 1988;259(12):1809–1810. doi:10.1001/jama.1988.03720120017017