Abstract
Fifteen DSM IV hypochondriacs from the outpatient psychiatry clinic of a general hospital were compared with fifteen DSM IV somatisation disorder patients from the same source, matched for age, gender and secondary (co-morbid diagnosis). They were in turn compared with a control group matched again and having the co-morbid diagnosis but no somatoform condition; a fourth group with a long term medical condition but no somatising were also compared. Subjects completed the Childhood Experience of Care and Abuse (CECA) and the COPE Coping Skills Inventory. The childhood antecedents were examined and in the case of somatisation disorder these individuals experienced higher levels of parental indifference, parental antipathy, role reversal and abuse than all the other study groups. The co-morbid controls had similar scores to the somatisation disorder sample in all domains. The hypchondriacs report childhoods more similar to the medical controls with high levels of parental concern, supervision and companionship. These findings support the notion that these two somatoform conditions are distinct from one another and that hypochondriasis is unlikely to be an early stage of somatisation disorder. The two clinical samples (hypochondriasis and somatisation disorder) were not found to be characterised by different coping styles. The hypochondriacal sample most commonly adopted active coping, planning and acceptance as strategies for coping with strain. The somatisation disorder group did show a slight tendency to report self reliant coping styles and denial as the previous literature would suggest. These findings did not approach statistical significance. The only scales where the scores reached statistical significance (<.05 level) were those related to substance use and humour as coping strategies. The group most likely to use substances were the co-morbid controls and the least likely the hypochondriacs, this difference was significant. The group most likely to use humour to cope were the medical controls and the least likely were the hypochondriacs.