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

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.