What are the treatment options for severe health anxiety that is causing feelings of impending death?

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Differential Diagnosis for Health Anxiety

The patient's symptoms of excessive worry about their health and fear of dying can be attributed to various diagnoses. Here's a categorized differential diagnosis:

  • Single most likely diagnosis
    • Generalized Anxiety Disorder (GAD): The patient's health anxiety and fear of dying are characteristic of GAD, which is a common mental health condition.
  • Other Likely diagnoses
    • Panic Disorder: The patient's fear of dying could be related to panic attacks, which are intense episodes of fear or discomfort.
    • Illness Anxiety Disorder: This condition is characterized by excessive worry about having a serious illness, despite medical reassurance.
    • Somatization Disorder: The patient's health anxiety could be a manifestation of somatization disorder, which involves physical symptoms with no clear medical explanation.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Cardiac conditions (e.g., myocardial infarction, arrhythmias): Although the patient's symptoms are likely anxiety-related, it's essential to rule out life-threatening cardiac conditions.
    • Pulmonary embolism: This is a potentially fatal condition that can cause sudden onset of anxiety, shortness of breath, and fear of dying.
    • Neurological conditions (e.g., seizures, multiple sclerosis): Certain neurological conditions can cause anxiety, fear, and physical symptoms that mimic health anxiety.
  • Rare diagnoses
    • Hypochondriasis: Although this condition is now referred to as Illness Anxiety Disorder in the DSM-5, it's still worth considering as a rare diagnosis.
    • Factitious Disorder: The patient's symptoms could be fabricated or exaggerated for attention or sympathy, although this is a rare and unlikely diagnosis.
    • Mitochondrial diseases: Certain rare genetic disorders, such as mitochondrial diseases, can cause anxiety, fear, and physical symptoms due to energy production defects in cells.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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