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], Haleigh Williams, B.S., Yashasvi Aryaputra[3]

Overview

Illness anxiety disorder is characterized by excessive health-related concerns, but unlike somatic symptom disorder, somatic symptoms are either absent or mild. Illness anxiety disorder results in an individual mistaking some sort of discomfort as a serious illness.

Historical Perspective

• During Greek times, people believed that the viscera of the hypochondria were the seat of melancholy. Hypochondria literally converts to "beneath the cartilage between the ribs and navel".

Classification

• Illness anxiety disorder falls under the category of anxiety disorders.

Pathophysiology

• There is limited information regarding pathophysiology in anxiety disorders.

Differential Illness anxiety disorder from other diseases

• Illness anxiety disorder must be differentiate from the following conditions:

• • 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

Risk factors for the development of illness anxiety disorder include:

• History of childhood abuse
• Serious childhood illness

Natural History, Complications and Prognosis

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.

”

History and Symptoms

Symptoms

Symptoms include:

• Checking your body multiple times in search of illness or other issues

• Going to the doctor very often to make sure that they are healthy

• Checking different medical sites and references frequently to see if they have an illness

Laboratory Findings

The laboratory test of patients with illness anxiety disorder are usually normal.

Imaging

The imaging studies of patients with illness anxiety disorder are usually normal.

Treatment

Psychotherapy

• The most effective treatment for illness anxiety disorder is cognitive behavioral therapy.

Medical Therapy

• Selective serotonin reuptake inhibitors are a possible treatment option for illness anxiety disorder, but not enough is known about this form of treatment yet.

Brain Stimulation Therapy

Information regarding brain stimulation therapy as a treatment option for illness anxiety disorder is not yet known.