Carl R. Darnall Army Medical Center - Health Library

Illness Anxiety Disorder

(Hypochondria; Hypochondriasis)

Definition

Illness anxiety disorder is a health anxiety disorder. It is often chronic. A person with illness anxiety disorder is often very anxious about their health. They have fears that a real or imagined minor physical symptom is a sign of serious illness. Even when several doctors assure them otherwise, the person is convinced that they have a serious disease. Psychiatric counseling and medications can relieve some, if not all, of the anxiety and suffering. Left untreated, illness anxiety disorder can be debilitating and affect daily function.

Causes  ^

It is often difficult to identify a specific cause for illness anxiety disorder. It may be a result of a combination of several factors.

Risk Factors  ^

Factors that may increase your chances of illness anxiety disorder:

  • Family history of illness anxiety disorder
  • Having a serious childhood illness
  • Psychiatric disorders such as depression, anxiety, or personality disorder
  • Physical, sexual, or emotional abuse in childhood
  • Observing violence in childhood
  • Stressful experience with your own or a loved one's illness
  • History of personal traumatic experience

Brain—Psychological Organ
Brain Man Face

Chemical imbalances and traumatic life experiences may contribute to the development of illness anxiety disorder.

Copyright © Nucleus Medical Media, Inc.

Symptoms  ^

Symptoms include:

  • Chronic fear of serious illness
  • Chronic fear that minor symptoms are signs of a serious illness
  • Many physical complaints that often change over time
  • The disorder:
    • Lasts at least 6 months
    • Causes major distress
    • Interferes with social life or work
  • You may:
    • Check yourself frequently
    • Make many doctor visits, sometimes in the same day
    • Seek repeated tests for the same symptoms
    • Repeatedly research information about specific illnesses and their symptom
    • Change healthcare providers frequently
    • Try multiple herbal remedies or other alternative treatments

Diagnosis  ^

You will be asked about your symptoms and medical history. A physical exam will be done. If the exam shows no disease, your doctor may begin to suspect illness anxiety disorder. If further testing also fails to uncover a known medical condition, your doctor may diagnosis you with illness anxiety disorder if:

  • Your fear of illness lasts for at least 6 months and does not improve with reassurance and negative testing
  • No other psychological disorder is causing your fear

Treatment  ^

Physician Relationship and Monitoring

Effective treatment involves consistent, supportive care from one doctor, often along with a mental health professional. Finding a healthcare provider who is willing to listen to your concerns, provide support, and avoid needless testing is key to recovery.

You may feel overwhelmed by your symptoms. They may even seem to control your life. Schedule frequent visits, regardless of symptoms, with one doctor you can trust. Expect your doctor to:

  • Validate your distress
  • Be supportive
  • Direct your attention away from symptoms and focus it on functioning in daily life
  • Discourage a sense of dependency and disability
  • Recommend psychiatric counseling and educational therapy

Psychological Counseling

Psychotherapy such as cognitive-behavior therapy and behavioral stress management can be effective in treating illness anxiety disorder. This involves regular counseling with a psychotherapist to recognize false beliefs, understand anxiety, and stop anxious behaviors.

Medications

Antidepressant medications (such as serotonin reuptake inhibitors) may help relieve the symptoms of illness anxiety disorder, but there is limited evidence.

Prevention  ^

There are no current guidelines to prevent illness anxiety disorder because the cause is not known.

RESOURCES:

American Counseling Association
https://www.counseling.org

American Psychiatric Association
https://www.psychiatry.org

CANADIAN RESOURCES:

Canadian Psychiatric Association
https://www.cpa-apc.org

Canadian Psychological Association
https://cpa.ca

REFERENCES:

Antidepressant efficacy in generalized anxiety disorder. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T900051/Antidepressant-efficacy-in-generalized-anxiety-disorder. Updated September 7, 2016. Accessed January 31, 2018.

Anxiety disorders. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml. Updated March 2016. Accessed January 31, 2018.

Greeven A, van Balkom AJ, Visser S, et al. Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a randomized controlled trial. Am J Psychiatry. 2007;164(1):91-99.

Illness anxiety disorder. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/psychiatric-disorders/somatic-symptom-and-related-disorders/illness-anxiety-disorder. Updated January 2018. Accessed January 31, 2018.

Somatic symptom disorder. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116198/Somatic-symptom-disorder. Updated Spetember 30, 2016. Accessed January 31, 2018.

Thomson AB, Page LA. Psychotherapies for hypochondriasis. Cochrane Database Syst Rev. 2007;(4):CD006520.

Last reviewed December 2017 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 1/31/2018