title: Health Anxiety and Its Relationship to Disability and Service Use: Findings From a Large Epidemiological Survey.
abstract: OBJECTIVE
  To explore the contribution of health anxiety to disability and use of mental health and medical services, independently of co-occurring mental and physical conditions.
  
  
  METHODS
  Data from the Australian National Survey of Mental Health and Wellbeing 2007 were analyzed (n = 8841). Participants were aged 16 to 85 years (mean [standard deviation] = 46.3 [19.0] years) and 54% were women.
  
  
  RESULTS
  Health anxiety accounted independently for high disability and service use. People with health anxiety were more likely to use both mental health (for psychiatrists: odds ratio [OR] = 2.1, 95% confidence interval [CI] = 1.2-3.5; for psychologists: OR = 1.9, 95% CI = 1.2-3.3) and specialist medical services (OR = 1.7, 95% CI = 1.2-2.3) than people without health anxiety. However, they were not high-frequency attenders to specialist mental health services (OR = 1.6 [95% CI = 0.9-3.0] and OR = 1.3 [95% CI = 0.6-2.9]) compared with people with other mental disorders (OR = 11.7 [95% CI = 4.3-31.8] and OR = 29.5 [95% CI = 13.5-64.6] for psychiatrists and psychologists, respectively). People with health anxiety were likely to be high-frequency attenders to general practice (OR = 2.0, 95% CI = 1.4-2.8) and specialist medical services (OR = 2.4, 95% CI = 1.7-3.6).
  
  
  CONCLUSIONS
  It is important to recognize and treat health anxiety, even when coexisting with other conditions, to prevent high disability burden and excessive service use. The cross-sectional design and self-reported outcomes may have resulted in overestimation of the associations. Future work is needed on actual service use using reviews of medical records.
authors.affiliation: From the Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University and Monash Health (Bobevski, Clarke, Meadows), Melbourne, Australia; and Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University (Bobevski), Melbourne, Australia.
authors.forename: Irene
authors.initials: I
authors.lastname: Bobevski
authors.forename: David M
authors.initials: DM
authors.lastname: Clarke
authors.forename: Graham
authors.initials: G
authors.lastname: Meadows
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology*; D001294:Attitude to Health; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology; D005260:Female; D058006:General Practice; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D006998:Hypochondriasis / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008511:Medicine; D001523:Mental Disorders / Q000453:epidemiology; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012649:Self Concept; D013315:Stress, Psychological / Q000453:epidemiology; D014739:Victoria / Q000453:epidemiology; D035862:Vulnerable Populations / Q000523:psychology; D055815:Young Adult