Illness Anxiety Disorder Flashcards
Patients with illness anxiety disorder may or may not. . .
. . . accept seeing a psychiatrist
In many cases the PCP may have to continue care with these patients since they refuse to consider that their condition may be psychiatric rather than organic
Dysmorphia
A condition in which one body part is perceived to be out of proportion to the rest of the body (eg too large or too small)
Somatic symptom disorder
A condition in which physical symptoms seem as if they are part of a general medical disorder although no general medical condition, other mental disorder, or substance is present.
In this case, psychological conflicts can be translated into physical problems or complaints.
Diagnostic criteria for Illness Anxiety Disorder
Preoccupation with fears of having a serious illness, along with a large degree of anxiety about health
Duration of at least 6 months.
Bodily symptoms are minor in nature and not the predominant problem
Preoccupation persists despite medical evaluation and reassurance.
Either engages in excessive activities to monitor health status OR conversely attempts to avoid health monitoring to not feel the excessive alarm that the anxiety produces.
Belief is not delusional or limited to a specific concern about appearance (suggesting other diagnoses)
Disorders that can look a lot like illness anxiety disorder
Delusional disorder, somatic type
Schizophrenia
Somatic symptom disorder
Body dysmorphia
Conversion disorder
Delusional disorder, somatic type vs illness anxiety disorder
Delusional disorder, somatic type: Specific illness or the delusions are ALWAYS the same. Patient cannot be reassured and WILL NOT CONSIDER alternative explanations for their somatic delusion.
Illness anxiety disorder: Bodily complaints or disease can change over time and are mild in nature. The patient can usually be reassured at least temporarily when presented with medical evidence.
Somatic symptom disorder vs illness anxiety disorder
Illness anxiety disorder: Patient’s fear is of having a serious disease. No specific age of onset.
Somatic symptom disorder: Patient’s primary concern is having many symptoms. If one of the symptoms is pain, the specifier “with predominant pain” is used. Typical age of onset prior to 30 years.
“Factitious disorder” is the new name for. . .
. . . Munchausen syndrome
Illness anxiety disorder vs OCD
Illness anxiety disorder: An obsessional belief with having a disease, typically without any specific compulsions.
OCD: Multiple obsessions and associated compulsive behaviors.
Treatment for Illness Anxiety Disorder
- Group therapy with patients suffering from similar disorders has shown to be helpful
- Insight-oriented therapy
- CBT
-
Regular physical exams have been shown to be helpful behaviorally
- Rather than as-needed. These allow the patient to regularly be evaluated by a phsyician rather than having to manifest an exacerbation in order to do so
- Inappropriate and non-indicated tests should NOT be performed in the evaluation of the patient
The most effective strategy for treating individuals with somatic symptom disorder
To schedule regular physical exams, rather than as-needed, coupled with education and resassurance.
With this approach, testing is often unnecessary. Treatment with an antianxiety medication or antidepressant is NEVER indicated for this condition.
