Illness Anxiety Disorder

About Illness Anxiety Disorder

Illness anxiety disorder, which together with somatic symptom disorder replaced the older diagnosis of hypochondriasis in DSM-5, involves preoccupation with having or acquiring a serious illness while physical symptoms are absent or only mild. The preoccupation persists despite appropriate medical evaluation and reassurance, is accompanied by high anxiety about health, and has lasted at least six months, though the feared illness may change over time. DSM-5 places it in the somatic symptom and related disorders chapter and describes a care seeking type, involving frequent checking of the body and repeated medical visits and tests, and a care avoidant type, in which medical care is avoided because of fear. Searching for health information online can intensify worry. Health anxiety often increases after a serious illness, a medical scare or the illness or death of someone close. The condition shares features with obsessive compulsive disorder, such as intrusive worries and reassurance seeking. Cognitive behavioral therapy has the strongest evidence and addresses catastrophic interpretations of bodily sensations, checking, reassurance seeking and avoidance. SSRIs are among the medications used. In medical settings, consistent care from a single primary clinician with regular scheduled visits can reduce unnecessary testing while acknowledging the distress. Many people improve with treatment.