Illness Anxiety Disorder
Clinical Symptoms of Illness Anxiety Disorder (Hypochondriasis)
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Patients with illness anxiety disorder (previously known as hypochondriasis) like those with somatic symptom disorderOpens in new window, also experience somatic amplification. The main feature of illness anxiety disorder is a preoccupation with fears of having a serious disease despite having no significant somatic symptoms.
Unlike somatic symptom disorderOpens in new window, patients with illness anxiety disorder catastrophically interpret minor bodily complaints as a sign of a severe illness. Concerns often have an obssessvie quality, with a compulsion to check with doctors, family, friends, and Internet sources for reassurance.
To meet the DSM criteria for diagnosis, these fears must lead to excessive care seeking or maladaptive avoidance behaviors that persist for at least 6 months.
People with this disorder are easily alarmed about their health, and they tend to worry about the possibility of cancer, heart attacks, AIDS, and strokes (Rachman, 2012). They may be haunted by powerful visual images of becoming ill or dying. They may react with anxiety when they hear about illnesses in their friends or in the broader community.
These fears are not easily calmed, and others may become frustrated when attempts to soothe worries fail. In response to these symptoms, primary care providers may suggest a consultation with a mental health professional, but the suggestion is typically refused.
The course of the illness is chronic and relapsing, with symptoms becoming amplified during times of increased stress. Depression may play a role. Consider the case of a 72-year-old woman with illness anxiety who was treated with electroconvulsive therapy (ECT)Opens in new window, a treatment most often used for depression. After one session her somatic complaints stopped abruptly. This patient’s success with ECT may indicate that depressive symptoms may have been the catalyst for her symptoms, leading to the diagnosis of illness anxiety (Dols et al., 2012).
Overall, the illness patient uses about 4% to 78% more health care services per year, excluding laboratory tests and x-rays prescribed in primary care, than patients with well-defined medical conditions (Fink, 2010).
As illness anxiety is so prevalent, it is important that clinicians achieve basic skills in treating and identifying this disorder. If patient health concerns are addressed at an early stage, repeated consultations, multiple trials of medications, and medical examinations may be prevented (Fink, 2010).
Frequent exposure to media messages reminding us to seek regular medical screenings may also contribute to fears about health (MacDonald, 2011). Studies show a relationship between exposure to breast cancer coverage in television programs to heightened fear of breast cancer (Lemal & den Bulck, 2009).
