People with illness anxiety disorder have an increased risk of mortality
A recent Swedish study has shed light on a paradoxical finding: individuals diagnosed with illness anxiety disorder, previously known as hypochondriasis, tend to have shorter lifespans compared to those who do not exhibit hypervigilance around health concerns. Illness anxiety disorder is a rare condition characterized by persistent fears of serious illness, even in the absence of physical evidence or abnormal test results. Some affected individuals may constantly change doctors, while others may avoid seeking medical care altogether.
Dr. Jonathan E. Alpert of Montefiore Medical Center in New York, who was not involved in the study, remarked, “Many of us are mild hypochondriacs. But there are also people on the other extreme of the spectrum who live in a perpetual state of worry and suffering and rumination about having a serious illness. It’s important to take it seriously and to treat it.” Treatment options for illness anxiety disorder can include cognitive behavioral therapy, relaxation techniques, education, and, in some cases, antidepressant medication.
The study, published in JAMA Psychiatry, addressed a significant gap in the existing literature. Led by David Mataix-Cols of the Karolinska Institute in Sweden, the researchers were fortunate to have access to the Swedish classification system for health statistics, which provided data on thousands of people over a 24-year period, from 1997 to 2020.
The findings revealed that individuals diagnosed with hypochondriasis faced an increased risk of mortality from both natural and unnatural causes, with suicide being particularly prevalent. The authors of the study suggested that chronic stress and its impact on the body could explain some of the observed differences in mortality rates.
Examining a cohort of 4,100 individuals diagnosed with hypochondriasis, the researchers matched them with 41,000 people of similar age, sex, and county of residence. Using a measurement called person years, which accounts for the number of individuals tracked and the duration of tracking, the study found that overall death rates were higher among those with hypochondriasis, at 8.5 per 1,000 person years compared to 5.5 in the control group. Furthermore, individuals with the disorder tended to die at a younger age, with a mean age of 70 versus 75 in the control group. The risk of death from circulatory and respiratory diseases was also higher among those diagnosed with hypochondriasis.
It is crucial to approach the referral of excessively anxious patients to mental health professionals with sensitivity and respect, according to Dr. Alpert, who leads the American Psychiatric Association’s council on research. Patients may feel accused of fabricating their symptoms, so it is important to convey that illness anxiety disorder is a legitimate condition with available treatments.
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