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Description of Health Anxiety

1.1    Terminology

Anxiety is a cognitive, emotional, physiological, and behavioral response to the perception of threat. It occurs when one doubts his or her ability to cope with the perceived threat.Health anxiety refers to inappropriate or excessive health-related fears based on misperceptions of innocuous bodily cues and sensations as indicative of a serious medical problem. Moreover, the individual with health anxiety perceives him or herself as unable to cope with or prevent the perceived threat, in this case the presence of a serious medical illness.

1.2    Definition

Definition of health anxiety and hypochondriasis

Anxiety is an adaptive response which prepares us to take action when confronted with possible danger (i.e., thefight or flight response). Some degree of health-related anxiety may therefore be constructive if it motivates a person to take appropriate measures or seek proper medical attention. For example, apprehension concerning shortness of breath in a person with asthma can lead to prompt administration of inhalant bronchodilator medication to prevent respiratory fatigue or even death by suffocation.Clinical health anxiety, on the other hand, is extreme in relation to the actual degree of threat (if any threat even exists). It causes distress and interferes with various domains of functioning, including interpersonal relationships, self-care, work or school, and leisure.

Hypochondriasis. Hypochondriasis is classified as a somatoform disorder in DSM-IV-TR (American Psychiatric Association [APA], 2000) and characterized by a preoccupation with fears of having, or the idea that one has, a serious medical condition such as a chronic, life threatening or life-altering sickness (seeTable 1). This“disease conviction” is (a) based on a misinterpretation of harmless or minor bodily sensations or perturbations and (b) persists in spite of appropriate medical evaluation and reassurance of good health.

The health-related preoccupation might concern specific bodily functions such as peristalsis or heart beat; slight benign abnormalities, signs, and sensations such as an occasional cough, pulled muscle, mole, or bruise on the skin; vague and ambiguous complaints such as“a hollow head” or“weak spine;” or specific organs (e.g., kidneys), body parts (e.g., prostate gland), or diseases (e.g., rabies, cancer).