Question

What is the background, etiology, diagnosis and treatment, of someone who has ILLNESS ANXIETY DISORDER? Please answer essay form

Answer 1

Illness anxiety disorder is a persistent fear of having a grave medical illness. A person with this disorder excessively attend to health. He gets easily alert by anything that might be interpreted as a sign of illness, including normal sensations, bodily functions and mild symptoms. That is, The patient's fears may derive from misinterpreting nonpathologic physical symptoms or normal bodily functions.

Illness Anxiety Disorder was previously known as hypochondriasis but due to the negative connotation or being a demeaning term, 'Hypochondriasis' no longer exists in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Instead, approximately 75% of individuals previously diagnosed with hypochondriasis are subsumed under the diagnosis of somatic symptom disorder. The remaining 25% have high health anxiety in the absence of somatic symptoms and are classified as having illness anxiety disorder.

Diagnostic Criteria:

A) Pre occupation with 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 medical condition(e.g., strong family history is present) the pre occupation 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 behaviours 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 a somatic symptom disorder, panic disorder, GAD, BDD, OCD or delusional disorder.

Etiology:

IAD is generally thought to be to be a chronic and relapsing condition with the age (onset of early and middle adulthood). The development and course of this is not clear yet  the risk factors include :

1) It may be caused by a major life stress.

2) A history of childhood abuse or a serious illness during childhood may add to susceptibility to this disorder in adulhood

3)Some people with this disorder have had a significant illness in the past, for example, during childhood

4) Illness anxiety disorder may be motivated by the advantages, such as relief from responsibilities along with the attention and care of family members, friends and doctors. Although the individual is often not aware of that motivation. When someone is consciously seeking such advantages, the condition is called malingering. But illness anxiety disorder is not malingering.

Prevention &Treatment:

Though there are no such preventive measures suggested for Illness Anxiety Disorder yet

1) The symptoms of illness anxiety disorder may be relieved by an antidepressant even when no other psychiatric illness is present

2) serotonin specific reuptake inhibitors (SSRIs) like fluoxetine or serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine might help

3) Therapies like : cognitive therapy, behavior therapy, cognitive behavior therapy and stress management may prove helpful.

4) Meditation, distraction and relaxation techniques might be useful as well

5) Affected person may be benefitted if he shares a  a trustful relationship with his physician. Reassurance is helpful when the primary care doctor provides it in the context of thoughtfully evaluating the physical complaints. Doctors and therapists should take physical symptoms seriously because symptoms are real.

Some patients respond well to medication, psychotherapy or both. A combination of support and care from the primary care doctor along with psychotherapy can be helpful.