Authors studied 57 young patients, aged from 16 to 25 years, with hypochondriac delusions in a psychotic episode. Four psychopathological types of psychotic episodes with hypochondriac delusions were singled out: depressive-hypochondriac, cenestho-hypochondriac, paranoid and polymorphic. An analysis of these types allowed to consider different mechanisms of the formation and relation of cenesthopathy with hypochondriac delusion. In episodes with the interpretative mechanism of delusion formation, the high frequency of psychasthenic and sensitive schizoids and the long preceding stage with dysmorphophobic, senesthopathic, depressive and overvalued hypochondriac disorders as well as somatic/autonomic pathology were observed. In episodes with mixed mechanisms of delusion formation, the presence of dysmorphophobic and cenestho-hypochondriac symptoms were not characteristic of the initial stage.