Care-avoidant type:  Medical care is rarely used.
Diagnostic Features
Most individuals with hypochondriasis are now classified as having somatic symptom
disorder; however, in a minority of cases, th e diagnosis of illness anxiety disorder applies
instead. Illness anxiety disorder entails a pr eoccupation with having or acquiring a seri-
ous, undiagnosed medical illness (Criterion A) . Somatic symptoms are not present or, if
present, are only mild in intensity (Criterion B). A thorough evaluation fails to identify a
serious medical condition that accounts for the individual’s concer ns. While the concern
may be derived from a nonpathological physica l sign or sensation, the individual’s dis-
tress emanates not primar ily from the physical complaint it self but rather from his or her
anxiety about the meaning, significance, or ca use of the complaint (i.e., the suspected med-
ical diagnosis). If a physical sign or symptom is present, it is often a normal physiological
sensation (e.g., orthostatic dizziness), a benign  and self-limited dysf unction (e.g., transient
tinnitus), or a bodily discomfo rt not generally considered indicative of disease (e.g., belch-
ing). If a diagnosable medical condition is present, the individual’s anxiety and preoccu-
pation are clearly excessive and disproportionate  to the severity of the condition (Criterion
B). Empirical evidence and existing literatur e pertain to previously defined DSM hypo-
chondriasis, and it is unclear to what extent and how precisely they apply to the descrip-
tion of this new diagnosis.
The preoccupation with the idea that one is  sick is accompanied by substantial anxiety
about health and disease (Criterion C). Indivi duals with illness anxiety disorder are easily