Illness Anxiety Disorder

Overview

• Very similar to DSM-IV hypochondriasis
• Clinical description:
  • Severe anxiety about the possibility of having or acquiring a serious disease
  • Actual symptoms are either very mild or absent
  • Strong disease conviction
  • Medical reassurance does not seem to help

DSM-5 Criteria

• A. Preoccupation with fears of having or acquiring a serious illness.
• B. Somatic symptoms aren’t 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.
• C. There is a high level of anxiety about health, and the individual is easily alarmed about personal health status.
• D. The individual performs excessive health-related behaviors or exhibits maladaptive avoidance.
• 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.
• F. The illness-related preoccupation is not better explained by another mental disorder, such as somatic symptom disorder, generalized anxiety disorder, or obsessive-compulsive disorder.
• 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.

Statistics

• Only 20% of patients who used to meet the diagnostic criteria for DSM-IV hypochondriasis now meet criteria for illness anxiety disorder
• Severe illness anxiety has a late age of onset, possibly because more physical health problems occur with aging
• Often comorbid with anxiety and mood disorders