Kancherla Neeraj, Vanka Srija Chowdary, Pokhrel Sandesh, Shahzadi Reshma Bano, Vijaya Durga Pradeep Ganipineni
Psychiatry, King George Hospital, Visakhapatnam, IND.
Psychiatry, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna Avutapalle, IND.
Cureus. 2022 May 27;14(5):e25416. doi: 10.7759/cureus.25416. eCollection 2022 May.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), characterises illness anxiety disorder (IAD) as the preoccupation with having or acquiring a serious illness in the absence of somatic symptoms (or, if present, symptoms that are only mild in severity). DSM-5 includes illness anxiety disorder in the category called somatic symptom and related disorders, characterised by prominent somatic concerns, distress, and impaired functioning. More often than in psychiatric settings, individuals with illness anxiety disorder are encountered in primary care and specialist medical settings. Despite negative laboratory results, the benign course of the alleged disease over time, and adequate reassurances from specialists, their conviction of being ill persists. Illness anxiety preoccupations are heterogeneous, and the degree of insight is variable. Their illness-related preoccupation interferes with their relationships with family, friends, and coworkers. They are frequently addicted to internet searches about their feared illness, inferring the worst from the information (or false information) they uncover. Patients with illness anxiety disorder often have comorbid psychopathology, especially anxiety and depressive disorders. Typically, illness anxiety disorder is chronic. Physical symptoms are absent or mild and frequently represent a misinterpretation of normal bodily sensations. This case report presents the case of a patient diagnosed with IAD by a psychiatrist. The patient had been seen by his primary care physician and therapist for three years without any improvement in his symptoms before he was referred to a psychiatrist. After undergoing a partial thyroidectomy in 2018, this patient has been experiencing increasing symptoms of recurrent anxiety/fear consistent with IAD, despite extensive medical examinations that have consistently revealed normal results.
《精神疾病诊断与统计手册》第五版(DSM - 5)将疾病焦虑障碍(IAD)定义为在没有躯体症状(或者即便存在躯体症状,其严重程度也仅为轻度)的情况下,对患有或患上严重疾病的过度担忧。DSM - 5将疾病焦虑障碍归入躯体症状及相关障碍类别,其特征为突出的躯体担忧、痛苦以及功能受损。与精神科环境相比,疾病焦虑障碍患者更多地出现在初级保健和专科医疗环境中。尽管实验室检查结果为阴性,所声称疾病的病程呈良性发展,且专科医生已给予充分的 reassurances,但他们仍然坚信自己患病。疾病焦虑的担忧是多种多样的,自知力程度也各不相同。他们与疾病相关的担忧干扰了他们与家人、朋友和同事的关系。他们常常沉迷于在互联网上搜索自己恐惧的疾病,从所发现的信息(或虚假信息)中推断出最坏的情况。疾病焦虑障碍患者通常伴有共病心理病理学问题,尤其是焦虑和抑郁障碍。通常情况下,疾病焦虑障碍是慢性的。躯体症状不存在或很轻微,且常常代表对正常身体感觉的错误解读。本病例报告介绍了一名被精神科医生诊断为IAD的患者的情况。在被转诊至精神科医生之前,该患者已被其初级保健医生和治疗师诊治了三年,但其症状没有任何改善。2018年接受部分甲状腺切除术后,尽管进行了广泛的医学检查,结果始终显示正常,但该患者一直经历着与IAD相符的复发性焦虑/恐惧症状的加重。