Illness Anxiety Disorder
The Difference between Hallucinations And Delusions
Townsend and Morgan (2018) define delusions as mistaken personal ideas that contradict a person’s intellect or ethnic heritage, despite evident evidence that the view is erroneous or unreasonable, the individual maintains it. Hallucinations are false sensory sensations that are unrelated to real-world stimuli (Townsend & Morgan, 2018). They can affect any of the five senses: auditory, visual, tactile, gustatory, and olfactory.
Disorders of adjustment – According to American Psychiatric Association (2020), anxiety about one’s health is a typical reaction to serious sickness and is not a mental condition. This type of non-pathological health anxiety is tied to the medical condition and is usually temporary.
Disorder of somatic symptoms – When considerable somatic symptoms are present, somatic symptom disorder is diagnosed. On the other hand, individuals suffering from an illness anxiety disorder have few bodily symptoms and are preoccupied with the concept that they are sick(American Psychiatric Association, 2020).
Anxiety problems – Persons suffering from illness anxiety disorder are concerned about a wide range of occurrences, conditions, or behaviors that could be connected to their wellbeing. In illness anxiety disorder, health anxiety and concerns are more persistent and lasting (American Psychiatric Association, 2020). Individuals suffering from sickness anxiety disorder may experience panic attacks due to their disease concerns.
Diagnosis and Reasoning
My diagnosis is illness anxiety disorder together with erotomanic and jealous delusional disorder (American Psychiatric Association, 2020; Townsend & Morgan, 2018). The patient has an unreasonable or erroneous perception of worsening physical symptoms, which leads to a concern with and the dread of developing a dangerous disease.
The patient describes having this pain in her neck, it aches, it spreads to her back, thinking there’s a lump, and she dreads to be cancer, despite sufficient reassurance that no organic disease can be identified. The dread becomes incapacitating as the patient agrees to be laid off because of her symptoms. Although symptoms may be minor or nonexistent, the individual is at risk. The patient also has erotomanic delusions as she believes Eric, her supervisor, is in love with her as well as Mr. Nehring, whom she believes is jealous and thinks she is a threat to her career.
Additional Questions Asked
Additional questions I would have asked include if they attend medical settings more regularly, given the majority of people with illness anxiety disorder get substantial but inadequate medical treatment, while some may be too frightened to seek medical help (American Psychiatric Association, 2020).
I will also ask if she doctor shops, as patients frequently see numerous doctors for the same illness and have continually negative diagnostic test findings(American Psychiatric Association, 2020). Medical attention can sometimes result in a paradoxical worsening of anxiety or iatrogenic effects from diagnostic tests and treatments. Individuals with the disease are often unsatisfied with their medical care and find it useless, sometimes believing that physicians do not take them seriously.
The second-line therapy for IAD is pharmacological medications. According to French and Hameed (2022), selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are drugs of choice in illness anxiety disorder. Clients who benefit from antidepressant therapy should be on maintenance medication for at least 6 to 12 months (French & Hameed, 2022). The vast majority of patients need both psychotherapy and prescription medications.
The fear of becoming ill is coupled with severe worry about illness and disease (Criterion C) (American Psychiatric Association, 2020). Patients suffering from illness anxiety disorder are terrified of imagined disease and symptoms, including hearing about another person’s illness or reading a health-related news report.
Their fears of undetected illness are unassuaged by appropriate medical proof, negative diagnostic tests, or a light course of therapy (American Psychiatric Association, 2020). Attempts by the physician to reassure and relieve symptoms often do not alleviate but rather aggravate the individual’s worries.
Diagnostic and Screening
The Health Preoccupation Diagnostic Interview is a standardized, interviewer-administered evaluation that assists in the identification of IAD (French & Hameed, 2022). This tool aids in diagnosing IAD by allowing the interviewer to explain a patient’s comments. It also distinguishes IAD from somatic symptom disorders and normal controls (French & Hameed, 2022). The primary drawbacks of this interview method are that it is time-consuming and labor-intensive, hence it is usually reserved for research reasons.
According to French and Hameed (2022), the first-line intervention for IAD is psychotherapy. Cognitive-behavioral therapy (CBT) is psychotherapy that involves behavioral modification tactics to cure the patient’s malfunctioning maladaptive cognitive beliefs. It addresses the patient’s tendency to excessively monitor their body for indicators of sickness. CBT also involves instruction on common bodily feelings and their variations. Willingness and attachment therapy, group therapy, and mindfulness-based cognitive therapy may also be used(French & Hameed, 2022).
American Psychiatric Association. (2020). Diagnostic and statistical manual of mental disorders, 5th ed.: DSM‐5. In The Wiley Encyclopedia of Personality and Individual Differences (pp. 125–129). Wiley. https://doi.org/10.1002/9781119547174.ch198
French, J. H., & Hameed, S. (2022). Illness anxiety disorder. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554399/
Townsend, M., & Morgan, K. (2018). Pocket guide to psychiatric nursing, 10e (10th ed.). F.A. Davis.