Health anxiety symptoms in children and adolescents diagnosed with OCD
Health anxiety (HA) is an overlooked area in paediatric research. Little is known about the occurrence of HA symptoms in a child and adolescent psychiatric setting, and there are no age-appropriate diagnostic criteria and only limited number of assessment tools. It is therefore likely that HA is seen as part of obsessive–compulsive disorder (OCD) due to construct overlap and the diagnostic uncertainty of HA in this age group. In the present study, the extent of HA symptoms was investigated in 94 children and adolescents with a primary ICD-10 diagnosis of OCD. Self-reported HA symptoms were assessed using the Childhood Illness Attitude Scales. Clinician-rated OCD symptoms and severity were measured using the Children’s Yale Brown Obsessive Compulsive Scale. Information on socio-demographics was obtained from the child’s/adolescent’s medical record. The distribution of HA symptoms resembled a normal curve shifted to the right compared with a normal population of Danish children, and 30 % presented with high HA symptoms. Chi-squared tests were used to examine the proportion of children and adolescents with high HA symptoms in relation to various clinical characteristics. Clinician-rated illness worries and comorbid anxiety disorder were associated with high self-reported HA symptoms. The results contribute to the understanding of how HA and OCD overlap conceptually in young patients and bring attention to the need for improved recognition of OCD patients dominated by illness worries. Further research in the description of childhood HA is important in order to understand whether HA is a distinct disorder early in life.
KeywordsChild and adolescent psychiatry Childhood Illness Attitude Scales Clinical sample Health anxiety Hypochondriasis Obsessive compulsive disorder
This study was supported by grants from the Lundbeck Foundation, the Lundbeck Foundation Travel Grant, “Fonden til Psykiatriens Fremme” and The Foundation at Centre for Child and Adolescent Psychiatry, Risskov, Denmark. We would like to extend our gratitude to Research Secretary Janne Vivelsted for extracting record information.
Compliance with ethical standards
The study was approved by the Central Denmark Region (R.No. 1-16-02-176-13). The National Committee on Health Research Ethics was consulted to ensure that the study complied with the Helsinki Declaration II. The parents of the participating children gave their informed consent prior to inclusion in the study. This paper does not contain information that discloses the identity of participants in this study.
Conflict of interest
The authors declare that they have no conflicts of interest.
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