Evidence map›Paper›PMID 41536221›Full record

ArticlePsychological medicine2026

Risk of substance-related problems in hypochondriasis.

Kayoko Isomura, Susanna Österman, Erik Hedman-Lagerlöf, Ralf Kuja-Halkola, Isabell Brikell, Zheng Chang, Brian M D'Onofrio, Henrik Larsson, Paul Lichtenstein, David Mataix-Cols and 3 more

Abstract read
In one paragraph

Article in Psychological medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Familial Clustering of Hypochondriasis.Psychotherapy and psychosomatics · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Kayoko IsomuraCenter for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-9736-717X
Susanna ÖstermanCenter for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.ORCID https://orcid.org/0000-0001-5031-5025
Erik Hedman-LagerlöfDivision of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Ralf Kuja-HalkolaDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-3765-2067
Isabell BrikellDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Zheng ChangDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Brian M D'OnofrioDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-5248-7434
Henrik LarssonDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Paul LichtensteinDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
David Mataix-ColsCenter for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-4545-0924
Lorena Fernández de la CruzCenter for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-1571-5485
Volen IvanovCenter for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Anna SidorchukCenter for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-8126-8177

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypochondriasis, or health anxiety disorder, is associated with increased mortality, mainly from potentially preventable causes. Substance misuse is a well-known contributor to premature death, yet its relationship with hypochondriasis remains unclear. We assessed the risk of broadly defined substance-related problems in individuals diagnosed with hypochondriasis.

methodsThis Swedish register-based matched cohort study included 4,129 individuals diagnosed with hypochondriasis in specialist services between 1997 and 2020 and 41,290 demographically matched unexposed individuals. Stratified Cox proportional hazards models were fitted to estimate hazard ratios (HRs) for the association between hypochondriasis and substance-related problems - defined as alcohol and drug use disorders, dispensed medications for alcohol dependence and opioid use disorders, and alcohol- and drug-related accidental poisonings, deaths, and suspected criminal offenses. Models were adjusted for sociodemographic variables, parental substance-related problems, and personal psychiatric history.

resultsSubstance-related problems were identified in 504 (12.2%) individuals with hypochondriasis and 1,924 (4.7%) matched unexposed individuals. After adjustment for sociodemographic and parental covariates, hypochondriasis was significantly associated with an increased risk of substance-related problems (HR, 2.55; 95% confidence interval [CI], 2.30-2.84). Similar results were observed in individuals without preexisting substance-related problems (HR, 2.85; 95% CI, 2.48-3.27). Further adjustment for psychiatric comorbidity, particularly anxiety and depression, reduced the risk estimates, but the associations remained statistically significant. In an additional analysis including primary care diagnoses of hypochondriasis (presumably reflecting less complex cases), the risk of substance-related problems remained elevated (HR, 1.61; 95% CI, 1.39-1.86).

conclusionImproved recognition of, and clinical awareness of substance misuse may help reduce long-term adverse outcomes in individuals with hypochondriasis.

Indexed as

HypochondriasisSubstance-Related DisordersAdultCohort StudiesFemaleHumansMaleMiddle AgedProportional Hazards ModelsRegistriesRisk FactorsSwedenYoung Adultepidemiologyhealth anxiety disorderhypochondriasissubstance-related problems

Identifiers

PMID41536221
PMCPMC12885346

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.