ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Public Mental Health
Risk of Self-harm in Patients with Hypochondriasis: A Population-Based Cohort Study
Provisionally accepted
- The Chinese University of Hong Kong, Shatin, China
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Objective: This study aimed to ascertain whether individuals diagnosed with hypochondriasis (HYPO) exhibit a heightened risk of self-harming behaviors in comparison to those without the disorder. Methods: In this matched cohort study, we conducted a review of electronic health records of all patients admitted to Hong Kong public hospitals for any reason between January 1, 1993, and December 31, 2022. A HYPO cohort comprising 906 patients was identified, along with a comparison cohort of 906 matched subjects. All participants were followed until the occurrence of a self-harm diagnosis, death from other causes, or the end of 2023, whichever came first. The risk of self-harm from the onset of HYPO was estimated using Cox proportional hazards regression models and competing risk analysis. Results: Over the 30-year duration of the study, the number of individuals exhibiting self-harm behavior was 51 (5.6%) in the HYPO group and 49 (5.4%) in the comparison group. Both groups demonstrated comparable proportions of subjects engaging in self-harm (χ2 = 0.01, p = 0.927). The incidence rates of self-harm were 43.4 per 10,000 person-years in the HYPO group and 38.2 per 10,000 person-years in the comparison group. After adjustment, the hazard and subhazard ratio for self-harm in the HYPO group relative to the comparison group was 0.87 (95% confidence interval, 0.55–1.38) and 0.84 (95% CI, 0.53–1.34; p = 0.474), respectively. Conclusions: We did not find significant evidence for an elevated risk of self-harm associated with HYPO. Future research is warranted to replicate these findings and to more comprehensively identify the potential unique risk factors for self-harm in this patient population.
Keywords: Hypochondriasis, self-harm, risk, Depression, Suicidal, cohort study
Received: 11 Aug 2025; Accepted: 18 Nov 2025.
Copyright: © 2025 Tang, Tsoi, Yip, Liew and Chan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wai Kwong Tang, tangwk@cuhk.edu.hk
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