Illness Anxiety Disorder.

Illness anxiety disorder was formerly known as “hypochondriasis,” which is still the term widely used among the public. In illness anxiety disorder, physical symptoms are either not experienced at the present time or are very mild. But severe anxiety is focused on the possibility of having or developing a serious disease.

If one or more physical symptoms are relatively severe and are associated with anxiety and distress the diagnosis would be somatic symptom disorder. In illness anxiety disorder the concern is primarily with the idea of being sick instead of the physical symptom itself.

Illness anxiety disorder and somatic symptom disorder share many features with the anxiety and mood disorders, particularly panic disorder, including similar age of onset, personality characteristics, and patterns of familial aggregation (running in families). Indeed, anxiety and mood disorders are often comorbid with somatic symptom disorders; that is, if individuals with somatic symptom disorders have additional diagnoses, these most likely are anxiety or mood disorders.

The essential problem is anxiety, but its expression is different from that of the other anxiety disorders. In these two disorders, the individual is preoccupied with bodily symptoms, misinterpreting them as indicative of illness or disease. Almost any physical sensation may become the basis for concern. Some may focus on normal bodily functions such as heart rate or perspiration, others on minor physical abnormalities such as a cough.


Diagnostic Criteria for Illness Anxiety Disorder.

A. Preoccupation with fears of having or acquiring a serious illness.

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.

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 (e.g., repeatedly checks his or her body for signs of illness) or exhibits maladaptive avoidance (e.g., avoids doctors’ appointments and hospitals).

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.


aulty interpretation of physical signs and sensations as evidence of physical illness is central. So almost everyone agrees that these disorders are basically disorders of cognition or perception with strong emotional contributions.

Individuals with somatic symptom disorders experience physical sensations common to all of us, but they quickly focus their attention on these sensations. If you also tend to misinterpret these as symptoms of illness, your anxiety will increase further. Increased anxiety produces additional physical symptoms, which creates a vicious cycle.

Participants with these disorders show enhanced perceptual sensitivity to illness cues. They also tend to interpret ambiguous stimuli as threatening. Thus, they quickly become aware (and frightened) of any sign of possible illness or disease. A minor headache, for example, might be interpreted as a sure sign of a brain tumor. The cause is unlikely to be found in isolated biological or psychological factors. There is every reason to believe the fundamental causes of these disorders are similar to those implicated in the anxiety disorders.

Somatic symptom disorders run in families and that there is a modest genetic contribution. But this contribution may be nonspecific, such as a tendency to overrespond to stress, and thus may be indistinguishable from the nonspecific genetic contribution to anxiety disorders. Hyperresponsivity might combine with a tendency to view negative life events as unpredictable and uncontrollable. Therefore, to be guarded against at all times.


Clinical reports indicate that reassurance and education seems to be effective in some cases “surprisingly”. Because, by definition, patients with these disorders are not supposed to benefit from reassurance about their health. Reassurance is usually given only briefly. However, by family doctors who have little time to provide the ongoing support and reassurance that might be necessary.

Hypochondriasis to receive either six sessions of cognitive-behavioral treatment (CBT) from trained therapists. Treatment as usual from primary care physicians. CBT focused on identifying and challenging illness-related misinterpretations of physical sensations and on showing patients how to create “symptoms” by focusing attention on certain body areas.

Drugs may help some people with somatic symptom disorders. Not surprisingly, these same types of drugs (antidepressants) are useful for anxiety and depression. In one study, CBT and the drug paroxetine (Paxil), a selective-serotonin reuptake inhibitor (SSRI), were both effective, but only CBT was significantly different from a
placebo condition.


David H. Barlow, V. Mark Durand. Abnormal Psychology, An Integrative Approach. (7th ed).

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