From the Guidelines
Illness Anxiety Disorder (IAD) is a condition characterized by excessive worry about having a serious illness, despite medical reassurance and minimal or no somatic symptoms.
Diagnosis of IAD
- Diagnosis is based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, which include excessive worry about having a serious illness, excessive health-related behaviors, and significant distress or impairment in social, occupational, or other areas of life 1.
- A thorough medical evaluation is necessary to rule out underlying medical conditions that may be contributing to the anxiety.
- Screening tools, such as the Generalized Anxiety Disorder 7-item scale (GAD-7), can be used to identify individuals with anxiety disorders, including IAD 2.
Management of IAD
- Cognitive-behavioral therapy (CBT) is a highly effective treatment for IAD, which helps individuals identify and challenge negative thought patterns and behaviors contributing to their anxiety 3.
- Other forms of psychotherapy, such as acceptance and commitment therapy (ACT), may also be effective in reducing symptoms of IAD.
- Medications, such as selective serotonin reuptake inhibitors (SSRIs), may be used as an adjunct to therapy in some cases, but are not typically the first line of treatment 4.
Key Considerations
- Early identification and treatment of IAD are crucial to prevent the development of more severe anxiety symptoms and to improve quality of life 5.
- A collaborative approach between healthcare providers, including primary care physicians and mental health specialists, is essential for effective management of IAD.
- Patient education and support are critical components of treatment, as individuals with IAD often require reassurance and guidance to manage their anxiety and improve their overall well-being.
From the Research
Overview of Illness Anxiety Disorder (IAD)
- Illness anxiety disorder (IAD) is characterized by preoccupation with fear of serious illness despite medical reassurance 6, 7, 8, 9
- IAD is common, debilitating, challenging to treat, and results in high healthcare utilization 6, 9
- Patients with IAD experience persistent anxiety or fear of having or acquiring a serious illness, which adversely affects their daily life 8, 9
Diagnosis of IAD
- IAD is defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) as the preoccupation with having or acquiring a serious illness, in the absence of somatic symptoms (or, if present, symptoms that are only mild in severity) 8
- Clinically significant health anxiety is common, with estimates ranging up to 13% in the general adult population 9
Management of IAD
- Evidence-based treatments, including psychopharmacology and cognitive behavioral therapy, can significantly alleviate symptoms 9
- A therapeutic alliance with patients with IAD is essential, rather than ordering expensive or unnecessary diagnostic tests or treatment 8, 10
- Collaboration between medical providers is essential to avoid the pitfalls of excess testing and medical treatment 9
- Cognitive behavioral therapy (CBT) can be an effective treatment for IAD, and can be integrated into medical care and decision-making 6, 10
- Minimizing medical work-up, reassurance, and reactive medication changes can help to simplify treatment and manage co-morbid conditions 6