(Also Called 'Hypochondriacs')
What is illness anxiety disorder (IAD)?
Illness anxiety disorder (IAD) is a recent term for what used to be diagnosed as hypochondriasis, or hypochondria. People diagnosed with IAD strongly believe they have a serious or life-threatening illness despite having no, or only mild, symptoms. Yet IAD patients’ concerns are to them very real. Even if they go to doctors and no illnesses are found, they are generally not reassured and their obsessive worry continues. IAD can also trigger worries in people who do have a physical illness that they are sicker than they really are. The disorder is not about the presence or absence of illness, but the psychological reaction.
What are the symptoms of illness anxiety disorder?
Symptoms of IAD may include:
- Excessive worry over having or getting a serious illness.
- Physical symptoms are not present or if present, only mild. If another illness is present, or there is a high risk for developing an illness, the person’s concern is out of proportion.
- High level of anxiety and alarm over personal health status.
- Excessive health-related behaviors (e.g., repeatedly checking body for signs of illness) or shows abnormal avoidance (e.g., avoiding doctors’ appointments and hospitals).
- Fear of illness is present for at least six months (but the specific disease that is feared may change over that time).
- Fear of illness is not due to another mental disorder.
What causes illness anxiety disorder?
The cause is not known, but certain factors may increase the risk of developing IAD:
- Major life stress
- A severe symptom believed to threaten one’s health (e.g., chest pain, memory issues)
- History of childhood abuse (physical, sexual, emotional) or neglect
- History of childhood illness
- Having another mental disorder (e.g., major depression, anxiety, obsessive compulsive disorders, psychotic disorders)
How is illness anxiety disorder diagnosed?
The diagnosis of IAD depends on symptoms reported by the patient, family members, or others close to the patient. It is important for the patient and associates to describe the symptoms accurately. Knowing when the symptoms started, how severe they are, and how often they occur is critical.
How long can illness anxiety disorder last?
IAD may occur once, multiple times, or continuously. The first signs of it are usually seen in early to middle adulthood (ages 25-35), but can come on at any age. It can wax and wane in intensity, but rarely goes away completely.
How is illness anxiety disorder treated?
The three goals of treatment for people with IAD are to:
- Continue to function as normally as possible
- Ease mental distress
- Stop overuse of medical services
The best way to achieve these goals depends a lot on the patient’s preferences, and on the presence or absence of other illnesses commonly associated with IAD.
In most if not all cases of IAD, the patient’s primary doctor should continue to play an important role. Reasons for this:
- The primary doctor can schedule regular office visits if necessary (e.g., every three to six months) to address the patient’s ongoing concerns. Patients are advised to stick with one doctor rather than “doctor-shop” (go from one specialist to another).
- The primary doctor can help the patient decide if referral to a specialist is needed. This helps limit the number of tests with their potential problems and side effects.
- Relying on one doctor who knows the patient well helps reduce costs and risks of too many office visits and tests.
- Some people with IAD have severe psychological distress that needs treatment by a mental health professional. The primary doctor can suggest these services, making sure to clarify the reason for the referral and how it might help.
Cognitive-behavioral therapy (a type of talk therapy) can help patients learn to cope with IAD and lead more productive lives. For some, medications for anxiety, depression, or other mental disorders may help.
What are the possible complications of illness anxiety disorder?
IAD itself is not life-threatening. However people with IAD (especially accompanied by clinical depression) can develop thoughts of suicide. Such thoughts or feelings should not be ignored. Most people are reluctant to talk about being depressed and especially about having suicidal thoughts. Hiding or ignoring such thoughts – and not getting help – can have tragic results.
Other complications may include:
- Overuse of medical and laboratory services
- Costly medical bills
- Complications from testing procedures
- Disability and unemployment
- Marital or family problems
What is the outlook for people with illness anxiety disorder?
In mild or moderate cases of IAD, the outlook is generally good. However, the severity of worry about having an illness can come and go.
Those with severe IAD and their families must do their best to avoid the possible complications listed above. Long-term regular but brief visits with the primary doctor may be necessary. In severe cases of IAD, appropriate psychological help and treatment for existing depression or severe anxiety is strongly advised.
Can illness anxiety disorder be prevented?
Unfortunately, there is no known prevention against IAD. However, providing the IAD patient with support and understanding may help reduce severity of the symptoms, and help the patient cope with the disorder.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 7/27/2015...#9886