Illness anxiety disorder

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]

Differential Diagnosis

• Persistent health-related anxiety
• Anxiety disorder
• Obsessive-compulsive disorder
• Major depressive disorder
• Schizophrenia
• Delusional disorder
• Major depressive disorder

Epidemiology and Demographics

Prevalence

The prevalence of illness anxiety disorder is 1,300 to 10,000 per 100,000 (1.3% to 10%) of the overall population.

Risk Factors

• History of childhood abuse
• Serious childhood illness

Natural History, Complications and Prognosis

Poor prognostic factors include:

• Decrement in physical function
• Damage to occupational performance
• History of sexual abuse

Diagnostic Criteria

A. Preoccupation with having or acquiring a serious illness.

AND

B. Somatic symptoms are not present or, if present, are only mild in intensity. If another medical condition is present or there is a high risk for developing a medical condition (e.g., strong family history is present), the preoccupation is clearly excessive or disproportionate.

AND

C. There is a high level of anxiety about health, and the individual is easily alarmed about personal health status.

AND

D. The individual performs excessive health-related behaviors (e.g., repeatedly checks his or her body for signs of illness) or exhibits maladaptive avoidance (e.g., avoids doctor appointments and hospitals).

AND

E. Illness preoccupation has been present for at least 6 months, but the specific illness that is feared may change over that period of time.

AND

F. The illness-related preoccupation is not better explained by another mental disorder, such as somatic symptom disorder, panic disorder, generalized anxiety disorder, body dysmorphic disorder, obsessive-compulsive disorder, or delusional disorder, somatic type.

Specify whether:

Care-seeking type: Medical care, including physician visits or undergoing tests and procedures, is frequently used.

Care-avoidant type: Medical care is rarely used.