Illness anxiety disorder: A qualitative study of people with health anxiety and their experiences seeking and avoiding medical care

疾病焦虑症:一项关于健康焦虑症患者及其寻求和回避医疗保健经历的定性研究

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Abstract

OBJECTIVE: Illness anxiety disorder (IAD) has two subtypes in the DSM-5: 'care-seeking' and 'care-avoidant', with a third subtype, 'care fluctuating' identified in previous research. This study explores the experiences of individuals with IAD when seeking and avoiding medical care. DESIGN AND METHODS: We recruited self-identified health-anxious individuals via online social media advertisements. Participants completed a demographic questionnaire and a diagnostic interview assessing IAD and comorbidities. Participants meeting IAD criteria (N = 37, mean age = 39, 76% female) completed a qualitative interview about their experiences seeking and avoiding medical care, analyzed using reflexive thematic analysis. RESULTS: Participants reported that internal and external factors influenced help-seeking behaviours. Internal factors were physical symptoms, worry, fear, reassurance-seeking, and the motivation to stay healthy for their children. External factors included past experiences with health professionals, cost of care, and a busy lifestyle. Worry about missing a serious disease, symptom severity, and emotional fatigue from repeated care-seeking contributed to fluctuations in help-seeking. Negative past experiences with health professionals also impacted willingness to seek medical care. CONCLUSIONS: Reasons behind different help-seeking behaviours in IAD are complex. This study provides insight into the help-seeking experiences of individuals with IAD and the factors influencing these behaviours, which can inform targeted treatment approaches for IAD.

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