adjustment disorder may be diagnosed. Howeve r, only when the health anxiety is of suf-
ficient duration, severity, and distress can illnes s anxiety disorder be diagnosed. Thus, the
diagnosis requires the continuous  persistence of disproportio nate health-related anxiety
for at least 6 months. 
Somatic symptom disorder. Somatic symptom disorder is diagnosed when significant
somatic symptoms are present. In contrast, individuals with illness anxiety disorder have
minimal somatic symptoms and are primarily concerned with the idea they are ill. 
Anxiety disorders. In generalized anxiety disorder, individuals worry about multiple
events, situations, or activiti es, only one of which may invol ve health. In panic disorder,
the individual may be concerned that the pani c attacks reflect the presence of a medical ill-
ness; however, although these individuals may have health an xiety, their anxiety is typi-
cally very acute and episodic. In illness anxi ety disorder, the health anxiety and fears are
more persistent and enduring. Individuals wi th illness anxiety disorder may experience
panic attacks that are triggere d by their illness concerns. 
Obsessive-compulsive and related disorders. Individuals with illness anxiety disor-
der may have intrusive though ts about having a disease and also may have associated
compulsive behaviors (e.g., seeking reassurance) . However, in illness anxiety disorder, the
preoccupations are usually focused on having  a disease, whereas in  obsessive-compulsive
disorder (OCD), the thoughts are intrusive an d are usually focused on fears of getting a
disease in the future. Most individuals with OCD have obsessions or compulsions involv-
ing other concerns in addition  to fears about contracting disease. In body dysmorphic dis-