Hello, this is Dr. Grande. Today's question is what is Illness Anxiety Disorder
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Now when we talk about illness anxiety disorder, we talk about a mental disorder where an individual is preoccupied with
concern about having a serious illness and this is an interesting disorder because it's fairly similar to
Obsessive Compulsive Disorder and there's even a debate in a mental health community
About whether or not Illness Anxiety disorder is really just a variant of OCD
So when we look at the criteria for Illness Anxiety Disorder
there's another interesting feature a lot of mental disorders in the DSM have a symptom criteria section and
Then other criteria so there may be
Nine symptoms in the symptom criteria section and somebody might have to meet four or five of those symptoms to qualify
For that criterion and then there are other criteria that have to qualify for as well
With illness anxiety disorder all of the different criteria are required
There is no section in the DSM with illness anxiety disorder
That has a number of symptoms where somebody only has to meet a certain
Number less than that for the diagnosis. For example if we consider
Borderline Personality Disorder that disorder has nine symptoms in the symptom criteria
But an individual only needs to have five of those to qualify for that diagnosis
So again with Illness Anxiety Disorder, all the symptoms are required. So the first symptom is a preoccupation
with having or
acquiring a serious illness
now the DSM doesn't specifically say that this would be a mental disorder or a
medical disorder but most of the time we interpret this as relating to a
possible medical disorder a concern over
having or getting a medical disorder
because we usually conceptualize this first criterion as
being related to medical disorders this brings up an important point in
terms of the distinction between a talk therapist and a physician
For example, I have a PhD in counselor education and supervision and I'm a licensed counselor
I'm not a physician and most talk therapists are not physicians either.
So with this particular diagnosis of illness anxiety disorder as a talk therapist you would be working with somebody
who has
complaints or concerns
about a medical disorder. So it's important to make the referral to a physician
so that you know
if they in fact have the disorder or don't
That's an important element in terms of the mental health treatment to know if that medical disorder is really there or not.
Now, of course a lot of times when we treat individuals with Illness Anxiety Disorder,
they have been referred by a physician and we already have the information that shows that they did not qualify for a
diagnosis of any type of
medical disorder at least not the medical disorder that they're worried about.
The second criterion is
that there are little or no
somatic symptoms. So there's another disorder which is difficult to differentiate from Illness Anxiety
Disorder called Somatic Symptom Disorder and I have another video that discusses these two disorders together.
With Illness Anxiety Disorder there can be
mild somatic symptoms but that's really not the emphasis as the symptom criterion suggests
the anxiety is not coming primarily from
physical sensations of the person's having but rather the meaning or significance of
having the illness that they're worried about having. The third symptom criterion is the individual is experiencing a high level anxiety
about health-related concerns.
The fourth is that there's excessive health-related behavior like checking or
maladaptive avoidance, so a lot of times we think of this disorder and compare it to OCD,
it's this particular symptom criterion that makes it difficult to distinguish the two because that health-related behavior
as I mentioned oftentimes involves checking and of course OCD
oftentimes involves checking.
The fifth symptom criteria is that the disturbance has been present for six months.
but the illness that the person is worried about can change in that time.
So a lot of times we think of Illness Anxiety Disorder, we think of one particular illness that the person is worried about having or
acquiring.
But sometimes with this disorder if they have evidence that shows that they don't have a particular medical disorder they were worried about,
Then they might develop a fear about another potential medical disorder.
So the illness can change but the disturbance would be present for at least six months and
The sixth symptom criterion is that this disturbance is not better explained by
another mental disorder and there's a number of mental disorders listed in the DSM as examples. One of them is OCD.
Again,
emphasizing this difficult differentiation between illness anxiety disorder and OCD
It's important to note here as well that somebody can have Obsessive Compulsive Disorder and
Illness Anxiety Disorder at the same time
These can be comorbid and oftentimes they are comorbid.
This six symptom criterion that not better explained by another mental disorder criterion
doesn't mean that the two can't co-occur.
It just means that if you're looking at a presentation that you think is Illness Anxiety Disorder and
the symptoms are in fact better explained by OCD
then you would consider OCD over illness anxiety disorder.
This can certainly become confusing but the term not better explained doesn't mean that the two are mutually exclusive,
that the two disorders cannot co-occur.
Now it's also important to note that with illness anxiety disorder. There are two subtypes
These are not specifiers but rather subtypes
So an individual would have to have one and only one of these subtypes
There's the care-seeking type and the care-avoiding type. So an individual with Illness Anxiety Disorder would have to be categorized as
one of these two types, they could not be assigned both types. Some other interesting associated characteristics with Illness Anxiety Disorder
include that there's usually not a desire for perfectionism with this disorder like we would see with OCD and
also, in terms of what medical disorder or serious illness somebody's worried about it's oftentimes not a
communicable illness so the concern would more likely be over a medical disorder like cancer or heart disease as
opposed to influenza.
Now in terms of the treatment for Illness Anxiety Disorder,
we don't have a lot of research on the treatment effectiveness for illness anxiety disorder specifically,
but generally we believe that mental health talk therapy is
somewhat effective in relieving the symptoms of Illness Anxiety Disorder.
I hope you found this description of Illness Anxiety Disorder to be interesting. Thanks for watching.