Johns Hopkins Psychiatry Guide

Illness Anxiety Disorder

Mary H. Thornquist, Ph.D., O. Joseph Bienvenu, M.D., Ph.D.
Illness Anxiety Disorder is a topic covered in the Johns Hopkins Psychiatry Guide.

To view the entire topic, please or purchase a subscription.

Official website of the Johns Hopkins Antibiotic (ABX), HIV, Diabetes, and Psychiatry Guides, powered by Unbound Medicine. Johns Hopkins Guide App for iOS, iPhone, iPad, and Android included. Explore these free sample topics:

Johns Hopkins Guides

-- The first section of this topic is shown below --

DEFINITION

  • Illness anxiety disorder is characterized by excessive anxiety and consuming preoccupation with illness in the absence of physical symptoms or when only mild physical symptoms are present.
  • Illness anxiety disorder is classified under the Somatic Symptom and Related Disorders section of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)[1].
    • Other diagnoses under this section include somatic symptom disorder, conversion disorder, and factitious disorder.
    • Illness anxiety disorder replaces the DSM-IV-TR[2] diagnosis of hypocondriasis.
    • Although illness anxiety disorder is listed under the Somatic Symptom and Related Disorders section of the DSM-5, it is also conceptualized as an anxiety disorder.
  • When considering this diagnosis, it is important to have a firm understanding of somatization.
    • Somatization is the expression of mental phenomena as physical (somatic) symptoms.
    • There is a continuum of unconscious/non-volitional display of symptoms (patient unaware of the non-physiologic nature of symptoms) to conscious/volitional display (patient aware of the non-physiologic nature of symptoms).
    • Also important is the difference between primary gain (positive internal motivations) vs. secondary gain (positive external motivations).
      • Primary gain example: A patient feels guilty about not being able to perform a task, but if there is a medical condition justifying this inability, the guilt diminishes.
      • Secondary gain examples: A patient is allowed to miss work and gets financial compensation as the result of a medical condition.
      • Any given patient with illness anxiety disorder will have primary and/or secondary gains associated.

-- To view the remaining sections of this topic, please or purchase a subscription --

Last updated: December 9, 2014