A Recommendation for the Management of Illness Anxiety Disorder Patients Abusing the Health Care System

Abstract

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.

The Prevalence of Illness Anxiety Disorder Among Adults in Taif City, Saudi Arabia: A Cross-Sectional Study

“…However, Almalki and his colleagues reported a case of IAD that abuses the health care supplements in Saudi Arabia and costs more than $170,000 due to his concerns about having cancer. Luckily enough, after many years of extensive investigations and expensive imaging, the family physician directed him to the psychiatry department and the patient improved after cognitive behavioral therapy [14].…”

“…Another study in India found that 7% of 400 outpatient attendees had IAD, often coupled with depression and anxiety [7]. A 2016 case report detailed a 73-year-old Saudi man undergoing unnecessary tests costing over $170,000 due to health anxiety, significantly impacting his life [14]. These diverse studies emphasize IAD's prevalence and its association with psychiatric conditions, which underscores the need for further research, particularly in places like Saudi Arabia.…”

Illness Anxiety Disorder: A Case Report and Brief Review of the Literature

“…The primary care provider (PCP) is typically trained to identify physical symptoms that are not found in patients with IAD. This results in excessive use of scarce medical resources, worsening the depletion of the health resources apart from wasting the physician's time and efforts [9]. It is not known how much money has been spent on this patient in total, but it is expected to run into several thousands of US dollars.…”

Cognitive behavioural intervention for health anxiety, somatosensory amplification, and depression in coronavirus disease 2019 anxiety: an interventional study in Iran

“…The study was conducted among college students of University of Guilan in Rasht, Iran. According to the DSM-5 criteria for illness anxiety disorder (American Psychiatric Association, 2013), considerations on illness anxiety (Almalki et al, 2016;van den Heuvel et al, 2014), and by the use of 8 items of the Short Health Anxiety Inventory, which were adapted to coronavirus disease anxiety (e.g. I usually feel at high risk for developing coronavirus disease), 150 participants were recruited by convenience sampling method.…”