Illness anxiety disorder

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Target exams

Red flags

• Active suicidal ideation, intent or plan — hypochondriasis cohorts show elevated suicide and all-cause mortality; same-day risk assessment
• Care-avoidant illness anxiety delaying presentation of true medical disease (e.g. ignored red-flag cancer or cardiac symptoms)
• Severe depression or functional collapse driven by disease conviction — escalate intensity of care
• Near-delusional disease conviction with secondary depression — treat health-anxiety pathway (CBT/SSRI) while excluding primary psychosis
• Iatrogenic harm from endless uncoordinated investigations reinforcing threat beliefs without new clinical change
• High ED/primary-care utilisation with doctor-shopping and ruptured therapeutic alliances