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What is illness anxiety disorder?

Illness anxiety disorder is characterized by preoccupation with having or acquiring a serious, undiagnosed medical illness. This diagnosis was newly introduced to the DSM-5 to replace the previous diagnosis of hypochondriasis. The prevalence of illness anxiety disorder seen in ambulatory medical populations is 3-8%, and equal between men and women.

What does illness anxiety disorder look like?

Risk Factors

  • Childhood adversity
  • Serious childhood illnesses
  • Major life stress
  • Serious but ultimately benign threat to individual's health

Differential Diagnosis

  • Other medical conditions
  • Adjustment disorders
  • Non-pathological health anxiety
  • Somatic symptom disorder
  • Anxiety disorders
  • Obsessive-compulsive and related disorders
  • Major depressive disorder
  • Psychotic disorders

How is illness anxiety disorder treated?

  • Selective serotonin reuptake inhibitors (SSRI)

Nursing Management

Causes & Behaviors:

  • Excessive worrying
  • Difficulty concentrating; decreased attention span
  • Feeling discomfort, apprehension, or helplessness
  • Restlessness, hyperactivity, or pacing
  • Impulsivity
  • Inability to discriminate harmful stimuli or situations

Interventions:

  • Maintain a calm, non threatening manner while working with the client
  • Reduce stimuli in the environment
  • Provide reassurance and comfort measures
  • Offer PRN medications for high levels of anxiety, and monitor for side effects
  • Encourage client to participate in relaxation techniques

References

[1] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.

[2] Boyd, M. A. (2019). Psychiatric & mental health nursing for Canadian practice. Wolters Kluwer.

[3] Townsend, M. C. (2015). Psychiatric mental health nursing. F.A. Davis.