Hypochondriasis

To the Editor: Dr. Barsky's Clinical Practice review of hypochondriasis (Nov. 8 issue)¹ omits a common and important feature of the symptom complex in many patients: anxiety-induced hyperventilation. The symptoms mentioned in the review — intermittent paresthesias, belching, atypical chest pain, chronic headache, dizziness, and tinnitus — are the typical manifestations of hyperventilation.² Unfortunately, most physicians ascribe these symptoms to organic causes and subject patients to multiple, unnecessary, and often expensive diagnostic studies. Even more unfortunately, these studies have false positive rates as high as 30 percent, as has been demonstrated with regard to exercise stress tests in women with . . .