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Illness Anxiety Disorder

Psychopathology, Epidemiology, Clinical Characteristics, and Treatment

Scarella, Timothy M., MD; Boland, Robert J., MD; Barsky, Arthur J., MD

doi: 10.1097/PSY.0000000000000691

ABSTRACT Illness anxiety disorder is a primary disorder of anxiety about having or developing a serious illness. The core feature is the cycle of worry and reassurance seeking regarding health, as opposed to a focus on relief of distress caused by somatic symptoms (as in Somatic Symptom Disorder). Clinically significant health anxiety is common, with estimates ranging up to 13% in the general adult population. There are evidence-based treatments, including psychopharmacology and cognitive behavioral therapy, that can significantly alleviate symptoms. An understanding of the core psychopathology and clinical features of illness anxiety disorder is essential to fostering a working alliance with patients with health anxiety, as is the maintenance of an empathic, curious, and nonjudgmental stance toward their anxiety. Collaboration between medical providers is essential to avoid the pitfalls of excess testing and medical treatment.

From the Department of Psychiatry (Scarella), Beth Israel Deaconess Medical Center; Harvard Medical School (Scarella, Boland, Barsky); and Department of Psychiatry (Boland, Barsky), Brigham and Women's Hospital, Boston, Massachusetts.

Address correspondence to Timothy M. Scarella, MD, Department of Psychiatry, Beth Israel Deaconess Medical Center, E Campus, Rabb-2, Boston, MA 02215. E-mail:

Received for publication May 24, 2018; revision received November 26, 2018.

Online date: April 27, 2019

Copyright © 2019 by American Psychosomatic Society
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