# Fear or concern about having a disease - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class AS90 - condition scope only, no dose · Illness Anxiety Disorder - StatPearls - NCBI Bookshelf (NBK554399) - https://www.ncbi.nlm.nih.gov/books/NBK554399/ · No dose - referral pathway, no medicine given in primary care - Verified date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text FEAR OR CONCERN ABOUT HAVING A DISEASE Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class AS90 - condition scope only, no dose · Illness Anxiety Disorder - StatPearls - NCBI Bookshelf (NBK554399) - https://www.ncbi.nlm.nih.gov/books/NBK554399/ · No dose - referral pathway, no medicine given in primary care Review status: REVIEWED against the source listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (10) - These patients come first to primary care rather than to mental health services - Dread of a serious underlying illness persists through normal examination, normal tests and repeated reassurance - Bodily symptoms are usually absent, and mild when they do occur - Where a real illness exists, the worry is plainly out of proportion to how severe it is [anxiety] - Negative results fail to satisfy, and several doctors are consulted for the same problem - They believe earlier doctors were careless and overlooked a grave illness with dire consequences - They inspect themselves again and again for skin lesions, hair loss or bodily change [hair loss · skin lesions] - Dwelling on death and disability, with work and social life markedly impaired - One pattern seeks care: heavy use of services, switching doctor, demanding more tests - The other pattern avoids care, fearing a doctor or a test will uncover a fatal disease TESTS (10) - This is a diagnosis of exclusion: examine fully and test to the symptoms before settling on it - Criterion: excessive worry over having or acquiring a crippling or fatal illness - Criterion: no bodily symptoms, or only mildly distressing ones - Criterion: with a real illness, or family-history risk of one, the anxiety is still excessive - Criterion: out-of-proportion health behaviour, such as checking the body over and over - Criterion: the picture has run at least 6 months - Criterion: no other psychiatric condition explains the preoccupation better - A structured interview separates it from somatic symptom disorder and from healthy people - That interview is slow and laborious, so in practice it stays a research instrument - Carrying a genuine medical disease does not rule this out, as the two can coexist IF NOT THIS - what else fits (11) - Exclude general medical disease first, then weigh somatic symptom, obsessive-compulsive, generalised anxiety and body dysmorphic disorders - Somatic symptom disorder carries many lasting bodily symptoms with dread about them - The separation: here bodily symptoms stay minimal and the belief of being diseased dominates - In obsessive-compulsive disorder the acts are ritualised and stereotyped, and the worries span several themes - Here the worry stays on health alone and does not reach other areas of living - Generalised anxiety disorder frets over nearly everything, tense, keyed up and on edge - Anxiety here is health-specific, where generalised anxiety runs to social, romantic and work matters - Body dysmorphic disorder fixes on appearance flaws that others barely notice - Those patients fear being ugly, not being ill - Conversion disorder, delusional disorder, or depression - A personality disorder, or schizophrenia Source StatPearls "Illness Anxiety Disorder" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult A common presenting complaint reflecting patient anxiety rather than a disease itself; the GP's role is reassurance, appropriate targeted testing, and referral to mental health if health anxiety is persistent or disabling - a diagnosed anxiety disorder would be coded and treated separately. - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why A common presenting complaint reflecting patient anxiety rather than a disease itself; the GP's role is reassurance, appropriate targeted testing, and referral to mental health if health anxiety is persistent or disabling - a diagnosed anxiety disorder would be coded and treated separately. Caution No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to. RED FLAG - Genuine physical symptoms being dismissed as just anxiety, functional impairment from the fear itself, suicidal ideation, or escalating reassurance-seeking despite negative work-up. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)