SHARE @ Advocate Health - Midwest - Scientific Day: Illness Anxiety Disorder and Frequent ED Usage: A Case Study
 

Affiliations

Aurora St Luke's Medical Center

Abstract

Introduction/Background:

Illness anxiety disorder is a mental health condition that often leads to frequent emergency room (ED) visits due to excessive worry about health and impulsive behaviors surrounding medical evaluation. This case report follows a 59-year-old male patient with illness anxiety disorder who was seen by a primary care physician (PCP) on a weekly basis over three years. Prior to these weekly visits, the patient had an average of 12 ED visits per month, often related to health anxieties. Over the course of the three-year period, alongside psychiatry support for medication management, cognitive behavioral therapy, and access to a 24-hour triage line, this resulted in a dramatic reduction of his ED visits to an average of 4 ED visits per month.

Description: Current literature highlights that individuals with illness anxiety disorder often experience heightened health-related anxiety and compulsive behaviors surrounding medical evaluation, which contributes to frequent ED visits. While there are limited published studies on illness anxiety alone, a greater depth of literature surrounding health anxiety supports comprehensive management, including regular medical follow-up, psychiatric care, and psychotherapy. This approach can significantly reduce unnecessary ED utilization in these populations. The role of the PCP remains the cornerstone of the management of illness anxiety disorder; however, this case uniquely demonstrates the efficacy of more frequent PCP follow-up and the significance of rapport building as well as providing continuity of care, reassurance, and addressing both physical and mental health concerns in an integrated manner.

Discussion:

The clinical importance of this case lies in the potential to not only reduce healthcare costs but also improve patient outcomes by offering a comprehensive, accessible care model. Future directions may include research into optimizing PCP involvement in patients with illness anxiety disorder and health anxiety, particularly exploring the long-term effects of weekly follow-up visits on both mental and physical health outcomes as well as evaluating the sustainability of reduced ED visits. The key takeaway from this case is the potential of frequent PCP follow-up and the power of the therapeutic relationship to substantially decrease unnecessary ED visits in patients with illness anxiety disorder and health anxiety. This approach promotes patient empowerment and reduces unnecessary healthcare utilization.

Presentation Notes

Presented at Scientific Day; May 21, 2025; Park Ridge, IL.

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May 21st, 11:41 AM May 21st, 1:15 PM

Illness Anxiety Disorder and Frequent ED Usage: A Case Study

Introduction/Background:

Illness anxiety disorder is a mental health condition that often leads to frequent emergency room (ED) visits due to excessive worry about health and impulsive behaviors surrounding medical evaluation. This case report follows a 59-year-old male patient with illness anxiety disorder who was seen by a primary care physician (PCP) on a weekly basis over three years. Prior to these weekly visits, the patient had an average of 12 ED visits per month, often related to health anxieties. Over the course of the three-year period, alongside psychiatry support for medication management, cognitive behavioral therapy, and access to a 24-hour triage line, this resulted in a dramatic reduction of his ED visits to an average of 4 ED visits per month.

Description: Current literature highlights that individuals with illness anxiety disorder often experience heightened health-related anxiety and compulsive behaviors surrounding medical evaluation, which contributes to frequent ED visits. While there are limited published studies on illness anxiety alone, a greater depth of literature surrounding health anxiety supports comprehensive management, including regular medical follow-up, psychiatric care, and psychotherapy. This approach can significantly reduce unnecessary ED utilization in these populations. The role of the PCP remains the cornerstone of the management of illness anxiety disorder; however, this case uniquely demonstrates the efficacy of more frequent PCP follow-up and the significance of rapport building as well as providing continuity of care, reassurance, and addressing both physical and mental health concerns in an integrated manner.

Discussion:

The clinical importance of this case lies in the potential to not only reduce healthcare costs but also improve patient outcomes by offering a comprehensive, accessible care model. Future directions may include research into optimizing PCP involvement in patients with illness anxiety disorder and health anxiety, particularly exploring the long-term effects of weekly follow-up visits on both mental and physical health outcomes as well as evaluating the sustainability of reduced ED visits. The key takeaway from this case is the potential of frequent PCP follow-up and the power of the therapeutic relationship to substantially decrease unnecessary ED visits in patients with illness anxiety disorder and health anxiety. This approach promotes patient empowerment and reduces unnecessary healthcare utilization.

 

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