Almalki Mohammad, Al-Tawayjri Ibrahim, Al-Anazi Ahmed, Mahmoud Sami, Al-Mohrej Ahmad
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Case Rep Psychiatry. 2016;2016:6073598. doi: 10.1155/2016/6073598. Epub 2016 May 25.
Introduction. Illness anxiety disorder (IAD) entails a preoccupation with having a serious, undiagnosed illness in which somatic symptoms are, if present, mild in intensity (American Psychiatric Association, 2013). Case Report. This is a case of seventy-three-year-old Saudi man who started visiting the primary health care center around twenty-five years ago. With concerns of having cancer, the patient continuously visited the hospital, costing over $170,000. Throughout this period, the patient has been exposed to extensive unnecessary imaging studies and laboratory tests that have effects on his life in all aspects with such concerns. Five years ago, a family doctor has put an end to that by directing the patient to the right path. The doctor made several actions; most importantly, he directed the patient to a cognitive behavioral therapy which significantly improved a range of hypochondriacal beliefs and attitudes. This patient's case demonstrates the fundamental importance of a proper health system that limits such patients from abusing the health system and depleting the medical resources. Moreover, this case emphasizes the important role of the family physician who can be the first physician to encounter such patients. Thus, proper understanding of the nature of such disorder is a key element for better diagnosis and management.
引言。疾病焦虑障碍（IAD）表现为对患有严重的、未被诊断出的疾病的过度担忧，若存在躯体症状，其强度也较为轻微（美国精神病学协会，2013年）。病例报告。这是一名73岁沙特男性的病例，他大约在25年前开始前往初级保健中心就诊。出于对患癌的担忧，该患者不断前往医院，花费超过17万美元。在此期间，患者接受了大量不必要的影像学检查和实验室检测，这些担忧在各方面都对他的生活产生了影响。五年前，一位家庭医生为他指明了正确的方向，从而结束了这种情况。这位医生采取了多项措施；最重要的是，他为患者安排了认知行为疗法，这显著改善了一系列疑病观念和态度。该患者的病例证明了一个合适的医疗体系的根本重要性，这种体系能够限制此类患者滥用医疗体系并耗尽医疗资源。此外，这个病例强调了家庭医生的重要作用，家庭医生可能是首批接诊此类患者的医生。因此，正确理解这种疾病的本质是更好地进行诊断和管理的关键要素。
