Illness Anxiety Disorder & Somatic Symptom Disorder*
- Redefined in DSM-V, as previously termed Hypochondriasis.
- Illness Anxiety Disorder (IAD) is differentiated from Somatic Symptom Disorder (SSD) in that IAD emphasizes a cycle of worry and reassurance seeking regarding health, rather than complaining of somatic symptoms.
- Differential diagnosis includes medical diagnoses and mental health diagnoses.
- Children with the diagnosis of IAD will likely continue into adolescence.
- Fear that typical bodily sensations (e.g., sounds of digestion, sweating, or a skin mark) are signs of life-threatening disease
- Heightened awareness of bodily sensations that trigger anxiety about a potential undiagnosed illness
- Fixation on a particular body system
- Spending significant amounts of time researching their health concerns; reassurance from medical providers often provides minimal comfort
- Agreement that fears are exaggerated, with difficulty accepting no organic etiology; frequently "doctor shop," moving from one provider to the next in the search of a provider who can confirm the suspected illness
- A. Excessive worry about having or developing a debilitating or life-threatening illness.
B. Somatic symptoms are absent. If somatic symptoms are present, they are only mildly distressing to the patient. If a medical condition is present or a high-risk for developing a medical condition is present (due to family history), the anxiety regarding the medical condition (or potential impending medical condition) is excessive.
C. Excessive concern and anxiety regarding health-related issues.
D. The individual exhibits disproportionate and redundant health-related behaviors, such as
repeatedly checking his or her body for indications of disease.
E. Symptoms have been present for at least 6 months
F. The illness-related preoccupation is not better explained by another psychiatric condition
-Care-seeking type: Medical care, including physician visits or undergoing tests and procedures, is over-utilized.
-Care-avoidant type: Medical care is rarely used or avoided.
- Patients may fluctuate between the two specifiers.
Treatment is usually similar to treatment for anxiety: cognitive behavior therapy (CBT) and medications such as SSRIs.
Assessment & Screening
There are no validated screening tools for IAD, but anxiety screening tools and obsessive-compulsive screening tools should be used to aid diagnosis.
- The Childhood Illness Attitude Scales (CIAS) is a research measure created by Wright & Asmundsen (2003) to measure symptoms of health anxiety in school-aged children; this scale is not widely used.
Position Papers, Practice Parameters & Treatment Guidelines
- None specific to Illness Anxiety Disorder
- Illness Anxiety Disorder: Psychopathology, Epidemiology, Clinical Characteristics, and Treatment (Scarella, Boland & Barsky, 2019)
- Pediatric Somatic Symptom Disorders (Malas, Ortiz-Aguayo, Giles & Ibeziako, 2017)
Resources for Families
*Content originally curated by Sarah Bascand, RN, MSN.