Illness anxiety disorder
- A preoccupation with having or acquiring a serious, undiagnosed medical illness. Previously referred to as hypochondriasis.
- A. Preoccupation with 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 doctor 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, panic disorder, generalized anxiety disorder, body dysmorphic disorder, obsessive-compulsive disorder, or delusional disorder, somatic type.
- Panic disorder
- Generalized anxiety disorder
- Depressive disorders
- Factitious disorder
- Somatic symptom disorder
- Conversion disorder
- Delusional disorder
- Body dysmorphic disorder
- Obsessive-compulsive disorder
- Difficult to diagnose, as often a diagnosis of exclusion. Refer to the patient's medical record for indication of repeated visits or recurrent testing.
- Reassure patient, but set clear, reasonable boundaries on extent of workup to be provided in the ED
- Close outpatient psychotherapy focused on establishing and maintaining a relationship with the patient.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.