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A large Swedish study has uncovered a paradox about people diagnosed with an excessive fear of serious illness: They tend to die earlier than people who aren’t hypervigilant about health concerns.

Hypochondriasis, now called illness anxiety disorder, is a rare condition with symptoms that go beyond average health worries. People with the disorder are unable to shake their fears despite normal physical exams and lab tests. Some may change doctors repeatedly. Others may avoid medical care.

“Many of us are mild hypochondriacs. But there are also people on the other extreme of the spectrum who live in a perpetual state of worry and suffering and rumination about having a serious illness,” said Dr. Jonathan E. Alpert of Montefiore Medical Center in New York.