Health anxiety

Question 1

Difference between health anxiety and panic

Answer 1

Similar to panic, in that the misinterpretation of bodily sensations commonly occurs. • However, health anxious patients also misinterpret other things, including bodily variations, medical information from doctors and from the media, and the results of health screening and tests. • Panic – misinterpretation of certain bodily sensations as a sign of imminent disaster (thinking palpitations are a sign of a coronary).
• Key differences:
• Relatively delayed time course in terms of the feared catastrophe
• Different behaviours (checking and reassurance seeking are prominent)

Question 2

Health anxiety DSM 5 criteria

Answer 2

A. Preoccupation with having or acquiring a serious illness
B. Somatic symptoms are not present or, if present, are only mild in intensity. If another medical condition is present or there is a high risk for developing a medical condition, the preoccupation is clearly excessive or disproportionate.
C. There is a high level of anxiety about health, and the individual is easily alarmed about personal health status. D. The individual performs excessive health-related behaviours or exhibits maladaptive avoidance.
E. Illness preoccupation has been present for at least 6 months, but the specific illness that is feared may change over that period of time.
F. The illness-related preoccupation is not better explained by another mental disorder (i.e. panic disorder).

Question 3

Triggers

Answer 3

• Stress
• After someone close to patient becomes seriously ill
• Death of someone close
• After patient has been ill or recovered from serious illness (breast cancer)

Question 4

Physical symptoms of health anxiety

Answer 4

• Usual physical symptoms of anxiety (chest pains, numbness, tingling)
• Noticing of changes in the body e.g. lumps, skin blemishes, heart fluttering & missing a beat

Question 5

Cognitive symptoms

Answer 5

• Misinterpret “normal” physical symptoms as signs of serious medical problems
• Worry takes shape of:
- Overestimate – symptom as serious illness - Overestimate – severity over illness
- Underestimate – coping ability

Question 6

Screening questions for illness anxiety

Answer 6

• Do you worry a lot about your physical health?
• Do you worry a lot that you have a serious disease that doctors haven’t been able to diagnose?
• What makes you think this?
• What do you think you have?
• How much time do you spend worrying about your physical health
• How often do you go and see the doctor because of health worries? Have there been times when the doctor has said there was nothing wrong? Did that reassure you? How long did the reassurance last?
• Does worry about health make you very upset, or interfere with your life