[The hypochondriacal delusion].
Hypochondriacal delusions are not bound to a specific mental disorder, but occur in the whole spectrum of psychoses. In spite of the implicitly wrong conception of reality, the significance of these delusions as an attempt to express, interpret and cope with mental illness should not be neglected if an approach to the patient's own experience is sought. On the one hand, hypochondriacal delusions are based on altered body perceptions in mental illness, characterized by primary local or general dysaesthesias to the point of depersonalisation, or caused secondarily by the patient's increased attention to his own body. This alienated bodily experience is named in (lay) medical terms by the delusional hypochondriac. On the other hand, "illness" with its manifold cultural and psychological meanings stands as a polyvalent metaphor for the incomprehensible alteration of the patient's self-experience in general: thus, the feeling of exposure to external attacks, of guilt, sinfulness, shame, loss of self-esteem or even the experience of a disruption of personality may find their expression in the hypochondriacal delusion.