Clinical study of illness anxiety disorder in medical outpatients

Sunayna Pandey,Ganpat Vankar,Mehul Brahmbhatt,Minakshi Parikh

doi:10.12740/app/76932

Abstract

Aim of the studyTo find out the prevalence of illness anxiety disorder (hypochondriasis) in medical outpatients and the risk factors and psychiatric co morbidities associated with it.Subject or material and methods400 consecutive medical outpatients were asked for socio demographic characteristics and risk factors associated with illness anxiety and were given Short Health anxiety inventory (SHAI). Psychiatric co-morbidities were assessed using Mini International Neuropsychiatric Interview (M.I.N.I). People who scored 18 or above in SHAI, the diagnosis of Illness anxiety disorder was confirmed by using DSM 5 criteria for illness anxiety disorder (IAD). The data was analyzed by using SPSS version 17, Chi square and t test.ResultsThe prevalence of IAD was 7%. Around 18% patients with IAD had positive family history for hypochondriasis. 32.1% of the patients had a history of abuse in the childhood. 71.4% of the patients had psychiatric co morbidities. 25% patients with IAD had co morbid depression and 28.6% had anxiety spectrum disorder.DiscussionThe range of prevalence of hypochondriasis is 0.4 to 14% in various studies and it is more common in third and fourth decade. Significant risk factors include divorce, family histrory and history of abuse. 65-88% of patients with hypochondriasis have psychiatric comorbidities like depression and anxiety disorders. Managing psychiatric comorbidities and early treatment of both will lead to better prognosis.ConclusionsThe anxiety of having a serious medical illness is reasonably high in patients attending medical O.P.D. About three fourth of these patients had co morbid psychiatric condition, mostly depression and anxiety disorders.

Highlights

The concept of dividing hypochondriac patients into those who misinterpret prominent somaticHypochondriasis has been eliminated as a disorder, in part because the name had negative connotations and was not conducive to an effective therapeutic relationship
According to DSM5, individuals with high health anxiety without somatic symptoms would receive a diagnosis of illness anxiety disorder
Patient sociodemographic data were collected by a semi-structured interview, and comprised information about demographic characteristics and risk factors associated with illness anxiety, such as a family history of hypochondriasis, a history of serious illness in childhood, a stressful experience with one’s own or a loved one’s illness

Summary

Introduction

The concept of dividing hypochondriac patients into those who misinterpret prominent somaticHypochondriasis has been eliminated as a disorder, in part because the name had negative connotations and was not conducive to an effective therapeutic relationship. Individuals with IAD may repeatedly contact doctors, seek additional tests, search the internet and medical texts, and seek reassurance from significant others about bodily sensations which have been appropriately evaluated and judged to be benign. Due to these emotional, cognitive and behavioral manifestations, hypochondriasis is often disruptive to social, occupational and family functioning and its associated medical costs can be substantial

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