What is a key goal of managing Illness Anxiety Disorder in primary care?

• A. Increase medical testing.
• B. Reduce excessive health-related behaviors and reassurance seeking; improve functioning with structured follow-up and CBT.
• C. Discontinue all follow-up.
• D. Refer all cases to psychiatry.

Answer: (B)

Illness anxiety disorder in primary care is best managed by reducing reassurance-seeking and excessive health-related behaviors, while improving daily functioning through a structured follow-up plan and cognitive-behavioral therapy. The idea is to address the cycle where worry prompts repeated testing and constant reassurance, which in turn maintains or heightens anxiety. A predictable schedule of follow-up visits provides a safety net and minimizes the need for unplanned, potentially reinforcing checks. Cognitive-behavioral therapy helps patients reinterpret bodily sensations, challenge catastrophic thoughts, and develop coping strategies that reduce avoidance and dependence on medical testing. By focusing on functioning and gradual exposure to normal health concerns, patients experience lasting improvement without becoming trapped in a pattern of endless reassurance. Increased medical testing often fuels anxiety rather than alleviating it, discontinuing all follow-up abandons care, and reflexively referring every case to psychiatry is unnecessary when many patients can be effectively managed in primary care with a structured plan and access to psychotherapy.