Personality Pathology and Functional Impairment in Patients With Hypochondriasis

Background: Research indicates substantial co-occur-ance of personality pathology and hypochondriasis, which both involve significant psychosocial impairment.Objective: This study sought to investigate the role of personality pathology for explaining functional impair-ment in patients with hypochondriasis, while accounting for the influence of health anxiety severity.Methods: Patients diagnosed with hypochondriasis (N = 84; 60% women) were administered interview-and self-report instruments for personality pathology, health anxiety severity, and functional impairment (general, social, and physical): The Structured Clinical Interview for DSM-IV Axis II (SCID-II), the Personality Inventory for DSM-5 (PID-5), the Short Health Anxiety Inventory (SHAI), the 36-item Short Form health survey (SF-36), and the Global Assessment of Functioning (GAF). Hi-erarchical regression analyses were performed with boot-strapping (1000 samples).Results: Findings overall showed that personality pathology incrementally explained functional impairment over the influence of health anxiety severity. More specifically, findings revealed that the incremental effect of PID-5 trait di-mensions was substantially larger than the SCID-II personality disorder criterion-count. Functional impairment was specifically associated with SCID-II symptoms of Avoidant Personality disorder and dependent personality disorder as well as PID-5 trait domains of negative affectivity, detachment, and psy-choticism.Conclusions: The findings highlight the po-tential significance of personality pathology for understanding and clinical management of functional impairment in patients with hypochondriasis. The per-sonality features that best explained functional impairment were avoidant personality disorder and dependent personality disorder and, in particular, DSM-5 and the International Classification of Dis-eases, 11th revision personality trait domains of nega-tive affectivity, detachment, and psychoticism.