Which therapy is evidence-based for Illness Anxiety Disorder and how does it differ from treating Somatic Symptom Disorder?

• A. Psychoanalytic therapy without exposure.
• B. Pharmacotherapy only.
• C. Cognitive-behavioral therapy with exposure to illness-related cues and worry management; may include SSRIs; treatment for IAD emphasizes reducing avoidance and reassurance-seeking, while SSD focuses on symptom acceptance and functional restoration.
• D. Lifestyle modification and relaxation training only.

Answer: (C)

The main idea here is that Illness Anxiety Disorder (IAD) responds best to a cognitive-behavioral approach that directly targets the fear and avoidance surrounding illness. This means CBT that includes exposure to illness-related cues and worry management. Exposing the person to situations or thoughts that trigger health fears helps them habituate to the anxiety and see that catastrophic outcomes are unlikely, while worry management teaches how to challenge and cope with these thoughts instead of ruminating on them. SSRIs can be added if anxiety or associated mood symptoms are prominent, but the core is breaking the cycle of avoidance and reassurance-seeking that keeps the fear alive. This differs from Somatic Symptom Disorder (SSD), where the focus is on managing distress and impairment from actual or perceived physical symptoms, with treatment aiming for symptom acceptance and functional restoration rather than reducing illness-related fears or avoidance. In SSD, while CBT can help, the emphasis shifts toward coping with symptoms and increasing daily functioning rather than primarily extinguishing fear of illness through exposure. So the best answer reflects CBT with exposure and worry management for IAD, potentially with SSRIs, and notes the distinct aims compared with SSD.