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

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