By Jennifer B. Wilcox Berman, PsyD, Lindner Center of HOPE

 

OCD and OCPD are often mistaken for one another or used interchangeably. Although there is some overlap between the two disorders, it’s important to distinguish between them because they are quite different in many ways. It is important to note that although there are differences, some people may have symptoms of both OCD and OCPD. The two disorders are differentiated below.

Obsessive-Compulsive Disorder (OCD) is a debilitating psychiatric disorder that presents in many forms. OCD is comprised of obsessions, which are persistent and unwanted intrusive thoughts, images, or urges. To reduce or eliminate this distress or discomfort, OCD sufferers begin to engage in compulsive behavior, which is ritualized behavior or mental acts, that serve to reduce their discomfort and anxiety. It should be noted that not all compulsions are outwardly observable and may include avoidance of triggers or engaging in mental compulsions. Unfortunately, engaging in compulsions or avoidance of triggers reinforces obsessive thinking. Therefore, the goal of treatment is to reduce compulsions while learning how to tolerate the distress that comes from intrusive thoughts. Some subtypes of OCD include fears related to contamination, scrupulosity (religious-based fears)/morality, fear of harming others (aggressive or sexual), ordering and arranging, repeating, and checking. There are several other subtypes of OCD not noted here. In OCD, these intrusive thoughts are considered ego-dystonic, meaning they are inconsistent with someone’s self-image, beliefs, and values. Therefore, these obsessions cause significant distress, anxiety, and worry and can greatly interfere with one’s life. People with OCD tend to seek help when these thoughts and behaviors cause problems in their life.

According to the Diagnostic and Statistical Manual of Mental Disorders (5th edition), Obsessive-Compulsive Personality Disorder (OCPD) is “a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control.” Due to this, people with OCPD struggle with flexibility, openness to new ideas, and are often inefficient at completing tasks due to perfectionism. Their rigidity and inflexibility can lead to preoccupation with details, rules, lists, order, organization, and schedules. They can hold themselves to perfectionistic standards that interfere with their ability to complete tasks. They are often overly devoted to work and productivity at the expense of leisure activities and interpersonal relationships, leading to a poor work-life balance. People with OCPD can be overly conscientious, very scrupulous, and are often inflexible about matters of ethics, morality, and personal values. Some people with OCPD tend to be miserly, may hoard money for the future, and may have difficulty discarding worn-out or useless items. They may appear to be stubborn or rigid, and may struggle to delegate tasks or work with others because they don’t believe others will do things to their high standards. OCPD is considered ego-syntonic, meaning that it is consistent with someone’s self-image, beliefs, and values. People with OCPD tend to feel validated in their patterns of rigidity and perfectionistic rules and schedules. Therefore, people with OCPD are less likely to seek treatment, unless their behavior begins to negatively impact those around them.

While Exposure and Response Prevention (ERP) is considered the “gold standard” treatment for OCD, there is no such definitive standard intervention for OCD. Exposure and Response Prevention (ERP) is a type of Cognitive-Behavior Therapy (CBT). Cognitive-Behavior Therapy varies from other types of talk therapy in that it is focused on changing thinking patterns and behaviors. It tends to be directed at the present, rather than the past and is goal-oriented and solution-focused. ERP aims to change behavioral patterns, allowing someone to confront their fears and therefore, reduce their OCD symptoms. Exposure refers to the direct confrontation of one’s fear through voluntarily taking steps towards their fears and triggers. Response Prevention refers to someone voluntarily agreeing to reduce their usual rituals and compulsions. It is very important for someone who is working on doing exposures to simultaneously refrain from engaging in compulsions. Without reducing or refraining from the related compulsions, the person cannot learn that they can tolerate the exposure or that the compulsion is unnecessary.

Treatment for OCPD tends to focus on the identification of rigid rules and lifestyle and how these things may be negatively impacting one’s life. Therapeutic intervention includes working on flexibility, willingness to make changes, and focusing on one’s values as motivation for change.

For those suffering from symptoms of OCD or OCPD, therapeutic intervention can be helpful. It is important to seek a specialized provider that can accurately diagnose and treat these disorders.

 

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Grant, J. E., Pinto, A., & Chamberlain, S. R., (Eds.) (2020). Obsessive compulsive personality disorder.    American Psychiatric Association Publishing.

Hyman, B. M., & Pedrick, C. (2010). The OCD workbook: Your guide to breaking free from obsessive-compulsive disorder (3rd ed.). New Harbinger.

 

Kevin Hines, a mental health advocate and survivor of a suicide attempt from the Golden Gate Bridge, will share his story

High Hopes, Lindner Center of HOPE’s fundraising auxiliary, presents An Evening of HOPE, May 30, 2024, at MegaCorp Pavilion. This will be a unique and impactful event featuring the renowned speaker, Kevin Hines, a mental health advocate and survivor of a suicide attempt from the Golden Gate Bridge.

An Evening of HOPE will take place on Thursday, May 30, 2024, at MegaCorp Pavilion, 101 W. 4th Street, Newport, Kentucky starting at 6pm with a cocktail hour and dinner and program to follow. Co-chairs are Amy Russert & Blake Gustafson.

There are several ways to get involved through registration or sponsorship.

Visit lindnercenter.ejoinme.org/HighHopes.

All proceeds from the event benefit Lindner Center of HOPE’s Transforming HOPE Campaign. Funds enable the Center to add more treatment units, expand wellness facilities, add clinical staff, increasing the number of patients served, and lessen the suffering of people with mental illness.

Kevin Hines, a mental health advocate and survivor of a suicide attempt from the Golden Gate Bridge, will share his story

High Hopes, Lindner Center of HOPE’s fundraising auxiliary, presents An Evening of HOPE, May 30, 2024, at MegaCorp Pavilion. This will be a unique and impactful event featuring the renowned speaker, Kevin Hines, a mental health advocate and survivor of a suicide attempt from the Golden Gate Bridge.

An Evening of HOPE will take place on Thursday, May 30, 2024, at MegaCorp Pavilion, 101 W. 4th Street, Newport, Kentucky starting at 6pm with a cocktail hour and dinner and program to follow. Co-chairs are Amy Russert & Blake Gustafson.

There are several ways to get involved through registration or sponsorship.

Visit lindnercenter.ejoinme.org/HighHopes.

All proceeds from the event benefit Lindner Center of HOPE’s Transforming HOPE Campaign. Funds enable the Center to add more treatment units, expand wellness facilities, add clinical staff, increasing the number of patients served, and lessen the suffering of people with mental illness.

Lindner Center of HOPE in Mason is a comprehensive mental health center providing excellent, patient-centered, scientifically-advanced care for individuals suffering with mental illness. A state-of-the-science, mental health center and charter member of the National Network of Depression Centers, the Center provides psychiatric hospitalization and partial hospitalization for individuals age 12-years-old and older, outpatient services for all ages, diagnostic and short-term residential services for adults, and research. The Center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The Center is also affiliated with the University of Cincinnati (UC) College of Medicine.

Trip to honor wife’s memory and raise awareness of the importance of friendship for mental wellness

Michael G. Leadbetter, MD, retired plastic surgeon, will launch his year-long friendship bus tour of the United States June 2024 raising awareness around the importance of friendship and connection for mental wellness. The trip is in memory of Leadbetter’s wife, Debbie, his life partner for 49 years. The couple had planned much of the trip before Debbie passed, with the goal of visiting friends around the country, highlighting the significant role friends played in their lives and their mental wellness. Leadbetter intends to donate $25 to Lindner Center of HOPE, a mental health center of excellence in Mason, Ohio, for every friend he interacts with on his journey. He is also hopeful that interested individuals that he meets will contribute to Lindner Center of HOPE and/or mental health causes of their own in recognition of his year-long tour. Leadbetter has a list of 150 friends he would like to visit who have played an important part in he and his wife’s journey.

Leadbetter and his wife lost their oldest daughter, who was living with bipolar disorder, to progressive illness caused by years of depression and uncontrolled addiction in 2020.  This devastating loss has fueled his passion for mental health.

“A person can hear, but a friend listens for meaning. A person can look, but a friend sees the heart. A person can know, but a friend understands your dreams. When in need, the Lindner Center of HOPE is where you will find your friends,” Leadbetter shared.

“A friend loveth at all times.” Proverbs 17:17

Leadbetter and Lindner Center of HOPE will have a launch party for the friendship bus tour on May 19, 2024, as part of Lindner Center of HOPE’s Community Education Day at The Manor House in Mason. The community event offers mental health education to local community members during a half-day event that includes a key-note speaker, resource fair and break-out sessions on mental health and wellness topics.

The official tour will begin in Brookville, Ohio, Leadbetter’s hometown on June 2 at a reunion with classmates from the classes of 1965 and 1966.

About Dr. Leadbetter

Leadbetter was a 1965 graduate of Brookville Ohio High School. He graduated from Otterbein University in Westerville, Ohio in 1969. In 1974 he graduated from The Ohio State College of Medicine. He completed his general surgery residency at The University of New Mexico in Albuquerque, New Mexico. He went on to complete his plastic surgery residency at The Christ Hospital, Cincinnati, Ohio. He was a founding member of the Plastic Surgery Group in Cincinnati where he practiced for 40 years before retiring in 2020. He is a board member of the Reid Rizzo Foundation. He is past president of the Ohio State College of Medicine Alumni Society and a past board member of The Cincinnati Music and Wellness Coalition.

Launch Events:

Lindner Center of HOPE Community Education Day
Sunday, May 19, 2024
Time: 12:45pm
Manor House, 7440 Mason Montgomery Rd., Mason, Ohio

 

Brookville Ohio
Monday, June 3, 2024
Time:  2pm
Location:  Golden Gate Park with high school classmates

 

Lindner Center of HOPE  provides excellent, patient-centered, scientifically advanced care for individuals suffering with mental illness. A state-of-the-science mental-health center and charter member of the National Network of Depression Centers, the center provides psychiatric hospitalization and partial hospitalization for adults, outpatient services for all ages, diagnostic and short-term residential services for adults, intensive outpatient program for substance abuse and co-occurring disorders for adults and research. The center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The center is also affiliated with the University of Cincinnati (UC) College of Medicine.

Half Day Workshop May 19th to Increase Awareness of Mental Health and Wellness

Lindner Center of HOPE will host Community Education Day on Sunday, May 19, 2024 in acknowledgement of May Mental Health Month at Manor House in Mason from 11am to 4pm. The half-day workshop offers an opportunity for community members to enhance their awareness of mental health and wellness. Knowledge helps break down stigma and open the conversation around prevention, treatment, and the mental health journey.

Brandon Saho, Creator of The Mental Game Podcast, Cincinnati native and former sports reporter with WLWT-TV will be the keynote speaker. Saho said goodbye to his dream job in 2022 to focus on his mental health. Saho says he was at his lowest. He was depressed and alone and he didn’t know how to live. Saho spent time as a patient at Lindner Center of HOPE and realized that he didn’t want anyone to struggle like he did, so he started The Mental Game podcast. Saho spends time talking with athletes, musicians, and celebrities with the goal of saving lives through these conversations.

Three sets of breakout sessions follow the keynote presentation. Attendees can design their afternoon according to their areas of interest with 12 total breakout sessions to choose from varying topics such as:  depression, self-care, empowered parenting, finding a therapist, addictions and more.

Just prior to the breakout sessions, attendees will be invited to participate in a friendly farewell to Michael G. Leadbetter, MD. Dr. Leadbetter, retired plastic surgeon, will launch his year-long friendship bus tour of the United States June 2024 raising awareness around the importance of friendship and connection for mental wellness. The trip is in memory of Leadbetter’s wife, Debbie, his life partner for 49 years. The couple had planned much of the trip before Debbie passed, with the goal of visiting friends around the country, highlighting the significant role friends played in their lives and their mental wellness.

Community Education Day also offers a resource center for participants to gather information on other community services and offerings.

Community Education Day 2024 Schedule

11am                     Registration and Resource Center Opens

11:30am              “Nourishing the Mind” Buffet

12pm                    Welcome by Paul Crosby, MD, MBA, President and CEO, Lindner Center of HOPE
Keynote by Brandon Saho, Creator, The Mental Game Podcast

12:45pm               Friendship Bus Launch for Michael Leadbetter, MD

1:15pm                 Breakout Session 1

2:15pm                 Breakout Session 2

3:15pm                 Breakout Session 3

Lindner Center of HOPE in Mason is a comprehensive mental health center providing excellent, patient-centered, scientifically-advanced care for individuals suffering with mental illness. A state-of-the-science, mental health center and charter member of the National Network of Depression Centers, the Center provides psychiatric hospitalization and partial hospitalization for individuals age 12-years-old and older, outpatient services for all ages, diagnostic and short-term residential services for adults, and research. The Center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The Center is also affiliated with the University of Cincinnati (UC) College of Medicine.

Kaila Busken, Lindner Center of HOPE, Licensed Independent Social Worker

One moment you are bursting at the seams with overwhelming joy. Every fiber of your being is filled with love for this tiny human being in your arms. Looking in your baby’s eyes, you feel like you have found your life’s purpose. And still, motherhood is really hard. New motherhood is sitting in the messy middle of seemingly opposite feelings. You can feel a mixed bag of emotions: sad and happy, overwhelmed, and peaceful, grief and joy, lost and found.

The transition to motherhood and its ambivalence has its own name: matrescence (pronounced like adolescence). The term was first developed by medical anthropologist Dana Raphael in 1973. This term is used to describe the bio-psycho-social- spiritual change that occurs when a woman makes the transition to motherhood. Like in adolescence, matrescence is a physical, hormonal, and emotional change all happening at the same time. Matrescence recognizes the large shift in identity that occurs when a woman becomes a mother and helps to normalize what it feels like to be in the middle of a whirlwind of emotions. Motherhood is a magical metamorphosis, because once you have a baby, nothing will ever be the same. And that is both beautiful and sad.

Around 15-20% of women who birth a child will experience postpartum mood disorders such as depression and anxiety. But matrescence is a normal part of motherhood and it is normal to feel ambivalence in this season of life.

Here are some helpful tips for coping in this new season of life:

1. Let go of expectations.
From the time a woman decides she is going to have children she hears an influx of information about what it means to be a mom and how to care for her baby. One of the biggest things a mom may hear is “you don’t have time for yourself anymore.” An important thing to remember is that you are a person worth caring for. You deserve to eat. You deserve a hot shower. You deserve to hydrate yourself. And you deserve love. You may even have a “Pinterest” perfect image in your head of what motherhood would be like. You may have pictured a blissful bubble in which you only feel complete happiness, but it is important to allow yourself to embrace the messiness and imperfection that is motherhood.

2.  Build your support system.
Just as a baby was born, you as a mother were born too. It is okay to ask for help and it is important to find a group of people who will help care for you. Look for people who will help support you emotionally while you adapt to your new role. Also look for people who will provide practical support like doing that pile of dirty dishes in your sink or the endless pile of laundry that babies create. Babies are tiny but they certainly require a village.

3.  Practice self-compassion.
Being a new mother is difficult. Suddenly this new little life is depending on you day and night and it can be exhausting.  It can be easy in this new vulnerable state to be harsh and self-critical. During this time, it is especially important to practice self-compassion and remind ourselves of our own worth. It can be easy to believe that you are a “bad” mother and that you are not providing what your baby needs. An important self-compassionate reminder is that “you are the best mother for your baby”. The goal is not for you to be a perfect mother but rather to be a “good enough” mother and embrace all the imperfection that comes with raising a baby. Perfection in motherhood is not possible and practicing self-compassion can help in remaining resilient in the face of this new role.

4.  Embrace the ambivalence.
Motherhood is embracing so much of the messy middle between seemingly opposing emotions. It can be uncomfortable to be in this place, where you want to spend every moment with your precious newborn and to crave the independence and space you had prior to having a baby. Motherhood is about the “both/and”, knowing that good and bad can exist in the same place. It is possible for you to embrace them both at the same time. You can love your baby with every fiber of your being and miss a time when you were able to sleep through the night or drink a hot cup of coffee.

5.  Allow yourself to grieve.
It is okay to grieve in this new phase of life. We tend to believe that grief is only reserved for death, but we can grieve many things in this new phase of motherhood. You may grieve your old life, previous relationship dynamics, your body and how it may have worked before, your time, your envisioned birth plan, your envisioned feeding plan, or your expectation of what you thought motherhood would be like. Allowing yourself to feel the sadness in some of these losses will help you to move on and embrace your new role as a mother.

April 17, 2024 6p-7p EST Manor House or virtual

Laurie Little, PsyD, Chief Patient Experience Officer and Staff Psychologist

The Silent Strain of Decision Fatigue

Participants will:

  • Learn what Decision Fatigue is.
  • Learn the negative consequences of Decision Fatigue.
  • Learn 3 coping strategies to manage the consequences of Decision Fatigue.

Click here for registration

 

REGISTER NOW! 1 CME/CEU OFFERED

Please join us April 9, 2024
5:30 – 6:30 p.m. EST

For a free webcast

Hypnotherapy & Trauma: Getting Past the Past

 

PRESENTED BY:
Chris Tuell, EdD, LPCC-S, LICDC-CS, Clinical Director of Addiction Services

Participants in the webcast will be able to:

  1. Outline the basics of Hypnotherapy.
  2. Define the role of Hypnotherapy for treating the patient with Trauma.
  3. Describe the current research regarding Hypnotherapy and Trauma.

Hypnotherapy & Trauma April 2024 webcast flyer

Register here

Target Audience:
Psychiatrists, Primary Care Physicians, Non-psychiatric MDs, Nurse Practitioners, , Social Workers, Psychologists, Registered Nurses, and Mental Health Specialists and interested parties as well

ACCREDITATION STATEMENT
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing
Medical Education (ACCME) through the joint providership of the University of Cincinnati and the Lindner Center of HOPE. The University of Cincinnati is accredited by the ACCME to provide continuing medical education for physicians.

The University of Cincinnati designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credits
commensurate with the extent of their participation in the activity.

The Ohio Psychological Association under approval number P099-311067501 (2010-2012) approves the University of Cincinnati College of Medicine
Department of Psychiatry for 1 mandatory continuing education credit for Ohio Licensed Psychologists.

The This activity has been approved for 1 clock hour of CEU by The State of Ohio Counselor, Social Work, Marriage and Family Therapist Board.

DISCLAIMER
The opinions expressed during the educational activity are those of the faculty and do not necessarily represent the views of the University of Cincinnati. The information is presented for the purpose of advancing the attendees’ professional development.

Lindner Center of HOPE Welcomes

Heather A. Dlugosz, MD, FAPA, CEDS

Medical Director, Lindner Center of HOPE Harold C. Schott Eating Disorders Program

Lindner Center of HOPE is pleased to announce that Heather Dlugosz has joined the Center in the role of Medical Director for the Harold C. Schott Eating Disorders Program. Dr. Dlugosz is an adult, child and adolescent psychiatrist specializing in the treatment of patients with eating disorders and their psychiatric co-morbidities including mood and anxiety disorders.

Dr. Dlugosz received her bachelor’s degree from Albion College.  She earned her M.D. from the University of Cincinnati College of Medicine, completed her adult psychiatric residency at University Hospital in Cincinnati, now the University of Cincinnati Medical Center and her child and adolescent psychiatry fellowship at Cincinnati Children’s Hospital Medical Center where she served as Chief Resident. She is board certified in Adult and Child and Adolescent Psychiatry and is a Fellow of the American Psychiatric Association and a Certified Eating Disorder Specialist (CEDS).

Dr. Dlugosz returns to Lindner Center of HOPE after previously working as a staff psychiatrist and then associate medical director at Eating Recovery Center in Cincinnati, OH and as a contract psychiatrist at VERY-Virtual Eating Recovery for You which provides virtual comprehensive services for patients with eating disorders. She currently holds an academic position as Associate Professor of Clinical-GEO at University of Cincinnati College of Medicine in the Department of Psychiatry and Behavioral Neuroscience where she helps to educate medical students and resident physicians in the treatment of eating disorders.

Dr. Dlugosz embraces a collaborative approach to the assessment and treatment of patients and her broad experience in a variety of settings is a solid foundation for providing the highest quality and compassionate care to patients at all levels of care.

The Center is excited about Dr. Dlugosz’s return and the leadership and expertise she will provide to the eating disorders treatment services.

By Angela Couch, RN, MSN, PMHNP-BC, Lindner Center of HOPE, Psychiatric Nurse Practitioner

Hypochondriasis has been replaced in the DSM 5 by Somatic Symptom Disorder (SSD) or Illness Anxiety Disorder (IAD), both categorized under Somatic Symptom and Related Disorders.  Previous diagnoses classified under Somatoform Disorders were often interpreted with a negative connotation, implying that the patient’s concerns were not real or valid. However, it is not appropriate to give a person a mental diagnosis for no other reason than no medical cause can be identified, nor does the presence of a medical diagnosis exclude a co-morbid mental disorder.  About 75% of persons previously diagnosed with Hypochondriasis will fall into the category of Somatic Symptom Disorder, while the other 25% will meet criteria for Illness Anxiety Disorder.  Let’s examine the differences.

Somatic Symptom Disorder (SSD), requires the patient to have one or more somatic symptoms (that is to say, pertaining to the body), that are distressing or result in significant disruption of daily life. Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns are manifested by at least one of the following: disproportionate and persistent thoughts about the seriousness of one’s symptoms, persistently high level of anxiety about health or symptoms, and excessive time and energy devoted to these symptoms or health concerns.  Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent, generally more than 6 months duration. Specifiers include predominant pain (formerly pain disorder), persistent, and mild, moderate or severe. High health anxiety can be a symptom of SSD but is not necessary for a diagnosis of SSD. Patients with SSD often seek care from multiple doctors and often feel their assessments were inadequate. Reassurance given does not seem adequate nor to last for these patients. Patients with SSD may worry that excessive physical activity may damage their body and may seem more sensitive to medication side effects.  The prevalence in adults may be 5-7% of the population, likely more common in females. In comparison to Obsessive-Compulsive Disorder (OCD), the recurrent worries are less intrusive and individuals may not exhibit repetitive behaviors aimed at reducing anxiety other than seeking assessment.  Usually in OCD, the obsessions would not be confined to somatic symptoms.

Illness Anxiety Disorder (IAD), requires the patient to have a preoccupation with having or acquiring a serious illness. Somatic symptoms are either not present or are mild in intensity. If another medical condition is present or there is a high likelihood of developing a medical condition, the preoccupation is excessive or disproportionate. There is a high level of anxiety about health and the individual is easily alarmed about their health status. The individual performs excessive health related behaviors, such as body checking, or exhibits maladaptive avoidance, such as avoiding medical assessment.  In IAD, the distress has been present for at least 6 months, though the specific illness targeted may change during that time. The preoccupation is not better explained by another mental disorder such as SSD, panic disorder, generalized anxiety disorder, body dysmorphic disorder, obsessive-compulsive disorder or delusional disorder. In IAD, the distress comes from the distress about the significance, meaning or cause of the complaint, not from a specific physical symptom or sensation. Most commonly, the physical symptoms exhibited are normal type sensations or considered benign or self-limiting dysfunction. Individuals who have IAD may be easily alarmed by reading or hearing about illnesses, and often will seek reassurance about illnesses through internet research or speaking to doctors or friends and family. In a smaller number of cases, the patient may be help avoidant versus help seeking. The reassurance given by medical professionals may potentially heighten the patient’s anxiety. Those who have IAD may avoid activities in order to avoid harming themselves or catching an illness from others.  The prevalence of IAD is possibly between 1.3-10% in the general population, and in ambulatory medical populations the 6-12 month prevalence is between 3-8%, and about equal across the sexes. The prevalence in OCD is also equal across the sexes. Persons with IAD may exhibit the intrusive thoughts about having a disease and may do compulsive behaviors such as reassurance seeking, but the preoccupations are usually focused on having a disease; in OCD, the intrusive thoughts are often about potentially getting a disease in the future or wanting certainty that they do not have one right now. In OCD, the obsessions and compulsions usually extend beyond disease concerns.

One study examined 118 treatment seeking patients with health anxiety, and gave them structured diagnostic interviews to assess for Hypochondriasis, IAD and SSD, as well as co-morbid mental disorders; additionally, the study looked at self-report measures of health anxiety, co-morbid symptoms, cognitions and behaviors, as well as service utilization. 45% of patients were diagnosed with SSD, 47% with IAD, and 8% with co-morbid SSD/IAD.  SSD and IAD were seen to be more reliable diagnoses than Hypochondriasis. Half of the sample group met criteria for Hypochondriasis, and of that sample, 56% met criteria for SSD, 36% for IAD, and 8% for co-morbid SSD/IAD.  SSD was characterized by higher levels of health anxiety, depression, somatic symptoms, and health service utilization, in addition to higher rates of major depression, panic disorder and agoraphobia.

Patients with these diagnoses often present in medical settings initially, and arrive in a mental health care setting via referral from another medical provider. It is important that medical providers validate the individual’s experience of symptoms and their anxiety, but also explain the rationale of supplementing medical interventions with mental health treatment.

Summary of Differences:

IAD                                                                             SSD

Absence/minimal distressing physical                Presence of distressing physical
symptoms                                                                  symptoms

 

High health anxiety not a requirement                 High health anxiety always present

 

Reassurance seeking common, but also             Reassurance/assessment seeking
less frequently can be care avoidant related
to anxiety

Equal across sexes                                                 More common in females

 

May engage in additional compulsions                More frequently associated with co-morbid depression, panic disorder,

higher level of health anxiety, and more utilization of medical services

 

References:

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.  Arlington, VA, American Psychiatric Association, 2013.

Newby, J.M., Hobbs, M.J., Mahoney, E.J., Shiu, W. and Andrews, G. DSM-5 illness anxiety disorder and somatic symptom disorder: Comorbidity, correlates, and overlap with DSM-IV hypochondriasis. Journal of Psychosomatic Research, 101, 31-37.