Mainstream cognitive behavioural theory stipulates that clinically significant health anxiety persists over time at least partially due to negatively reinforced health-related behaviours, but there exists no broad and psychometrically valid measure of such behaviours.

To draft and evaluate a new self-report scale – the Health Anxiety Behavior Inventory (HABI) – for the measurement of negatively reinforced health anxiety behaviours.

We drafted the HABI from a pool of 20 candidate items administered in a clinical trial at screening, and before and after cognitive behaviour therapy (n=204). A psychometric evaluation focused on factor structure, internal consistency, convergent and discriminant validity, test–retest reliability, and sensitivity to change.

Based on factor analysis, the HABI was completed as a 12-item instrument with a four-dimensional factor structure corresponding to the following scales: (i) bodily preoccupation and checking, (ii) information- and reassurance-seeking, (iii) prevention and planning, and (iv) overt avoidance. Factor inter-correlations were modest. The internal consistency (α=.73–.87) and 2-week test–retest reliability (r=.75–.90) of the scales was adequate. The bodily preoccupation and checking, and information- and reassurance-seeking scales were most strongly correlated with the cognitive and emotional components of health anxiety (r=0.41, 0.48), and to a lower extent correlated to depressive symptoms and disability. Change scores in all HABI scales correlated with improvement in the cognitive and emotional components of health anxiety during cognitive behaviour therapy.

The HABI appears to reliably measure negatively reinforced behaviours commonly seen in clinically significant health anxiety, and might be clinically useful in the treatment of health anxiety.

Restrictions to minimize social contact was necessary to prevent the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus but may have impacted individuals’ mental well-being. Emotional responses are modulated by contextual information. Living abroad during the coronavirus disease 2019 (COVID-19) pandemic may have boosted the feeling of isolation as the context is unfamiliar.

This study compared the psychological impact of social distancing in national students (living in a familiar context) versus international students (living in an unfamiliar context).

During March/April 2020 (first lockdown in the Netherlands), 850 university students completed an online survey. Structural equation modeling (SEM) was conducted to compare how students’ responses to the virus were predicted by health anxiety, emotional distress, and personal traits.

Compared with national students, international students showed higher levels in 4 identified factors (COVID-19-related worry, perceived risk of infection, distance from possibly contaminated objects, distance from social situations). The factors were mainly predicted by health anxiety across international students, while emotional distress and individual traits (eg, intolerance of uncertainty) played a role across national students.

In the familiar context, individual characteristics (traits) predicted the responses to the virus, while the unfamiliar context drove individuals’ health-focused responses. Living in a foreign country is associated with psychological burdens and this should be considered by universities for more pronounced social support and clear references to health-related institutions.

Memory complaint in the absence of organic pathology is a common phenomenon accounting for up to one third of patients presenting to memory clinics. Health anxiety has been specifically linked to dementia worry and repeated presentations to the National Health Service (NHS). Providing reassurance that an individual does not have dementia appears ineffective in reducing presentations to primary and secondary care services.

This study sought to evaluate and establish the effectiveness of a 1-hour pilot training workshop to enhance healthcare professionals’ knowledge and confidence to those with health anxiety around cognitive decline.

The one-session pilot training workshop was developed and informed by previous work and consultation with the 2Gether NHS Foundation Trust Memory Assessment Service staff. The training workshop was then evaluated by employing an idiosyncratic self-report questionnaire. Participants completed the questionnaire prior to and after the training workshop.

Pre- and post-training questionnaires revealed that the pilot training workshop was effective in increasing perceived knowledge and confidence in staff responding to patients presenting with health anxiety and co-occurring subjective memory complaints.

The findings suggest that healthcare professionals may benefit from training in identifying and addressing health-anxious individuals with subjective memory complaints. This may have implications in the provision of psychologically informed care offered in a memory assessment service. Recommendations are made for further enhancing the effectiveness of staff training and promoting alternative service treatment pathways.

Adolescents (especially frequently ill) from families where parents show high concern for their health, often themselves make complaints about their health status that do not receive medical confirmation (Kovalenko, 1998; Dielman et al., 1991). A study by T. Dillman and colleagues (1991) revealed a direct link between the perception of the disease in parents and children – the more seriously the parent perceives the child’s condition, the more seriously the child treats it, and the more complaints he has.

To study the influence of family on health anxiety in frequently ill adolescents.

The sample: 98 adolescents (mean age 16.1±0.9), 84 their parents (mean age 44.5±5.0). We used: “Short Health Anxiety Inventory” (SHAI; Salkovskis et al., 2002), The “Research on health-saving activities” (RHSA) questionnaire (Yakovleva, 2014), Questionnaire “Index of attitude toward health” (Deryabo, Yasvin, 1999).

The results of multiple regression analysis showed that health anxiety in adolescents is determined by the following parent’s features: goal-setting in the field of health-preserving activity (-0.661, p=0.036), standards of health (0.518, p=0.028), self-efficacy in the field of health-preserving activity (0.892, p=0.010), cognitive scale of attitude toward health (0.586, p=0.032) and scale of actions (0.059, p=0.002). It is also determined by parents’ vigilance to bodily sensations (0.815, p=0.000).

Health anxiety in adolescents is influenced by both cognitive, motivational and behavioral components of the attitude toward health of their parents, and also sensory (negative physical sensations and symptoms in parents form anxiety about health of their children). Research is supported by the Russian Science Foundation, project No. 21-18-00624.

Research is supported by the Russian Science Foundation, project No. 21-18-00624.

It is known that a high level of health anxiety is traditionally recognized as obligatory for hypochondria, which is characterized by a clear and pronounced belief of the subject in the presence of a disease or the danger of its development (A psychiatric glossary, 1975). Such patients are usually characterized by high concern about their health, but this anxiety can be represented by varying degrees of severity. At the same time, it is important to talk not only about pathological anxiety (hypochondria), but also about conditions associated with normal human anxiety about their health, also in children and adolescents.

To study health anxiety in younger adolescents.

The sample: 101 respondents (44 rarely ill younger adolescents (mean age 10.6±0.1), 57 frequently ill younger adolescents (mean age 10.5±0.43)). We used: “Short Health Anxiety Inventory” (SHAI; Salkovskis et al., 2002), Questionnaire “Index of attitude toward health” (Deryabo, Yasvin, 1999), CPQ (Porter, Cattell, 1985).

The results of multiple regression analysis for a sample of younger adolescents showed that the scale of actions to preserve and promote health and factor I (sensitivity) make up the level of severity of the general scale of health anxiety in rarely ill younger teenagers (-0.476, p=0.045; 0.628, p=0.039). Health anxiety is determined by factor O (anxiety) in frequently ill younger teenagers (0.316, p=0.029).

Health anxiety can be viewed as a non-pathological construct associated with personality traits and behavior and has structural differences depending on the diseases’ frequency. Research is supported by the Russian Science Foundation, project No. 21-18-00624.

Research is supported by the Russian Science Foundation, project No. 21-18-00624.

Health anxiety in attendees of out-patient medical clinics is well established; however, there has been a lack of research into health anxiety within emergency settings.

This study explored the prevalence of health anxiety in ambulatory presentations in a tertiary emergency department (ED) as well as the factors associated with pain and health anxiety in this setting.

A cross-sectional questionnaire design was used to gather data from adult ED ambulatory attendees across a 4-day sampling period to assess psychological and physical health variables. Number of attendances to ED over the previous 12 months was accessed through healthcare records.

Of the final sample (n = 106), 77% were white British, 54% were male, and 14% presented with severe health anxiety as measured by the Short Health Anxiety Inventory (≥18). Participants with pre-existing health conditions had significantly higher levels of health anxiety (M = 12.36, SE = 1.59) compared with those without (M = 7.79, SE = 0.66). Stepwise multiple regression analyses identified anxiety sensitivity and pain catastrophizing as significant independent predictors of health anxiety, explaining 51% of the variance in health anxiety. Pain catastrophizing was also a significant independent predictor of pain level, accounting for 20% of the variance.

This study provides insight into the prevalence of health anxiety in ED ambulatory presentations and key psychological predictors of health anxiety and pain. This has implications for treatment in an ED setting whereby patients may benefit from referral to medical psychology or mental health services.

The study’s aims were (i) to identify the prevalence of health anxiety (HA) among the elderly in urban community healthcare centers and (ii) to determine whether HA is related to social, physical, or psychological factors.

It is a population-based observational study.

Data were collected from urban community healthcare centers in Chengdu, China, from October 2016 to March 2017.

A total of 893 participants aged ≥ 60 years.

The Short HA Inventory was used for HA assessment. Mental health status was assessed using the Geriatric Depression Inventory and Mini-Mental State Examination. Other information was collected through face-to-face interviews. Data analysis was performed using SPSS 19.0.

The point prevalence rate of HA was 9.53% (95%CI = 6.99%–12.07%). The number of chronic diseases was a positive factor associated with HA in a regression analysis. As compared with participants without chronic diseases, people with one (OR = 1.796; 95%CI = 0.546–5.909), two (OR = 2.922; 95%CI = 0.897–9.511), and three chronic diseases (OR = 6.448; 95%CI = 2.147–19.363) had higher odds of suffering from HA.

The prevalence of HA was high in the elderly population. Certain physical conditions, such as having chronic diseases, were significant impact factors. More attention should be paid to the situation of HA in this population.

Compliance with government-recommended preventive measures represents a key factor in mitigating the negative consequences of coronavirus disease 2019 (COVID-19).

The study investigated the relation between health anxiety, perceived risk and perceived control as predictors of coronavirus disease 2019 (COVID-19)-related anxiety and preventive behaviours (both adaptive and dysfunctional/excessive) during the early pandemic response in Romania.

Data were collected in April–May 2020, and the sample comprised 236 participants, 192 women, mean age 31.44 (s.d. = 10.30, age range 16–67).

Our results showed that health anxiety and perceived control, but not perceived risk predicted adaptive preventive behaviours, whereas dysfunctional behaviours were predicted by health anxiety alone. COVID-19-related anxiety was predicted by health anxiety and perceived risk, with perceived control emerging as a non-significant predictor. Also, we found that the effect of health anxiety on COVID-19-related anxiety was mediated by perceived risk, and that perceived control acted as a moderator in the relation between health anxiety and dysfunctional (but not adaptive) preventive behaviours.

Our results suggest health anxiety is a significant predictor of COVID-19-related anxiety and preventive behaviours. Also, adaptive, but not dysfunctional, preventive behaviours were additionally predicted by perceived control, pointing to the important role of control and self-efficacy in explaining adherence to recommendations.

Mental health concerns are common in health care workers during pandemic. There are no studies of the prevalence of health anxiety in ophthalmologists in India.

To estimate the prevalence of health anxiety in ophthalmologists practicing in India during the ongoing pandemic.

A questionnaire-based online survey on the “changes and challenges during COVID-19” using Google forms was sent to all members of the All India Ophthalmological Society. Besides demographics, the survey had questions to assess the general mental and medical health status of the ophthalmologists. Short Health Anxiety Inventory (SHAI) was used to assess health anxiety.

1027 ophthalmologists responded to the study. Higher stress was experience by 83.1% compared to pre-COVID while examining patients closely (35.9%) or during surgery due to the risk of aerosol generation (29.3%). SHAI score >20 was observed in 5.6%. Only emergency services were being provided by 50% and 17% in the SHAI > 20 group were not working as compared to overall 14%.

Our findings indicate that a majority of the ophthalmologists were under stress during the COVID-19 pandemic but only a small proportion experienced health anxiety. It is likely that mental health issues may arise among ophthalmologists in the foreseeable future.

Cyberchondria is a pathological behaviour linked to excessive online searching of health information.It is frequently associated with health anxiety. It may be regarded as an compulsive behaviour secondary to obsessions about a real or an imagined illness. The coronavirus pandemic of 2019 has brought about a fear of getting infected. In the absence of a definitive cure, the focus largely lies on stringent preventive measures and early diagnosis. Known to present with diverse symptoms, fear of coronaviral infection makes affected individuals search for symptoms on internet for reassurance. Added misinformation further increases stress,anxiety and confusion.

The authors attempt to describe cyberchondria and highlight its increased prevalence during the coronavirus pandemic.

5 cases from different backgrounds were seen in the outpatient clinic during the months of April-July 2020.Consent was obtained from subjects before the study.They were clinically diagnosed with obsessive-compulsive disorder and exhibited cyberchondria in the background of the pandemic.

All of the described 5 cases had prominent fear of contracting or having contracted coronavirus disease-19.All of them were found to have significant scores rang on Yale-Brown Obsessive-Compulsive Severity Scale(ranging from 25-35) and improved after a trial of selective serotonin reuptake inhibitors.

The emergence of cyberchondria during the coronavirus -19 pandemic warrants further introspection.Changes in policy-making to prevent misinformation and present health information in a simple way to prevent confusion in the lay public is a necessity to tackle this problem in the near future.

The 2019 coronavirus disease (COVID-19) is a global health crisis that originated in China. As an adjacent city to the origin of COVID-19, Hong Kong has been facing different public health challenges raised by the epidemic.

This paper examined the prevalence of common physical symptoms, psychological symptoms, somatic symptoms, and health anxiety among the Hong Kong youth population.

HKYES is an on-going territory-wide epidemiological study collecting youth mental health data with randomly stratified sampling. Participants aged 15-24 years were to complete a physical symptom checklist, Depression, Anxiety and Stress Scale (DASS-21), Insomnia Severity Index (ISI), Patient Health Questionnaire-15 (PHQ-15), and Short Health Anxiety Inventory (SHAI).

A total of 594 participants have completed the survey since April 2020. The three most common physical symptoms were headache (n=106, 17.8%), fever (n=94, 15.8%) and fatigue (n=78, 13.1%). The mean scores of DASS depression, anxiety and stress subscales were 7.98 (SD 8.14), 5.81 (SD 6.32), and 8.83 (SD 7.93) respectively. Among all, 135 (22.8%) participants reported moderate to severe levels of depressive symptoms, 133 (22.4%) reported moderate to severe levels of anxiety symptoms, and 71 (12%) reported moderate to severe levels of stress. There were 40 (6.7%) and 60 (10.1%) participants showing significant levels of insomnia and somatic symptoms, while around one-third of the participants reported a high level of health anxiety.

Youth is at risk of severe psychological impact during the coronavirus. Monitoring the mental health trajectory for youth should become routine practice during times of crisis.

As significance of medically unexplained symptoms increases in general practice it is important to discuss psychopathological comorbidity regarding the impact of health anxiety indicating sufferers excessive care use.

To study the impact of health anxiety in depression with somatic symptoms.

50 patients with depression with somatic symptoms compared to 79 patients with psychodermatological disorders with complaints of pathological skin sensations completed the Hospital Anxiety and Depression Scale (HADS) and the Short Health Anxiety Inventory (SHAI). The Mann-Whitney U-Test was applied. The psychosemantic method “Classification of sensations” was used to differentiate patients’ bodily experience. Factor analysis was performed.

Scores on HADS-anxiety and SHAI were significantly higher in depression (U=645, p=0.009; U=89.5; p=0.036), although there were no significant differences on HADS-depression. Factor analysis showed a polarization of bodily experience categories in depression as the first factor (38% of total variance) included negative emotions with somatic sensations of exhaustion and the second factor (10% of total variance) included pleasant sensations and positive emotions with the negative sign of factor loadings. In psychodermatological disorders the first factor (31% of total variance) was quite similar, however the second factor (12% of total variance) included skin and general somatic sensations illustrating the higher concern with somatic symptoms.

Higher health anxiety in depression with somatic symptoms compared to psychodermatological disorders (more concerned with bodily experience) could be associated with patients’ complaints of emotional state indicating differences in psychological mechanisms. The research was supported by Russian Foundation for Basic Research with the Grant 20-013-00799.

This study aimed to assess the compliance to voluntary home quarantine and to examine the prevalence and associated factors of health anxiety among the voluntary home quarantined population during the onset of the coronavirus disease (COVID-19) pandemic.

An online survey questionnaire, including the health anxiety questionnaire, was administered to 1578 eligible adults from the general population of 19 governorates of Iraq.

Self-reported compliance with home confinement was reported by a majority of respondents (83%) and was followed to a larger extent by young adults (62.2%), females (53.9%), unmarried individuals (56.7%), university graduates (54.5%), unemployed individuals (48.6%), and inhabitants of the northern provinces (50.2%). Compliance was significantly correlated to the level of personal knowledge on COVID-19. The quarantined individuals experienced greater health anxieties and preoccupations and exhibited increased reassurance-seeking behavior. Higher knowledge of COVID-19 was a protective factor against health anxiety.

A significant mental health burden is discovered among Iraqis during the quarantine period. Based on the insights gleaned from this study, psychological education and interventions should be prioritized to diminish the psychological impact of the quarantine experience, especially among the high-risk groups. Improvement in compliance to quarantine can be approached by providing better information regarding the novel infection.

The unified protocol (UP) is indicated when patients present with co-morbidity, but no studies have previously investigated the effectiveness of the UP with co-morbid health anxiety and depression.

An A/B single case design evaluated outcomes for a 27-year-old male presenting with health anxiety and co-morbid depression. Following a 21-day assessment-baseline period containing three sessions, the manualised UP was delivered across a 42-day period containing seven intervention sessions. Four idiographic measures (occurrence and duration of health checking, sleep duration and food intake satisfaction) were collected daily throughout, and two nomothetic measures were collected at four time points.

All sessions were attended. Number of health checking episodes reduced from four per day to two per day. A 59 minute per day reduction in time spent health checking occurred, and sleep increased by 100 minutes per night. There was little apparent change in terms of food intake satisfaction. There was a reliable and clinically significant reduction in depression.

Further testing of the effectiveness of the UP with co-morbid health anxiety and depression in true single case experimental designs is now indicated.

1. (1) To understand the different barriers to completing the SHAI in a ME/CFS service.

2. (2) To understand the implications of administering the SHAI to ME/CFS service users.

3. (3) To learn from multi-disciplinary ME/CFS health professionals about perceived difficulties in administering the SHAI.

Health anxiety (HA) is associated with increased risk of disability, increased health care utilization and reduced quality of life. However, there is no consensus on which factors are important for the level of HA. The aim of this study was to explore the distribution of HA in a general adult population and to investigate whether demographic and social factors were associated with HA.

This study used cross-sectional data from the seventh Tromsø study. A total of 18 064 participants aged 40 years or older were included in the analysis. The six-item Whiteley Index (WI-6) with a 5-point Likert scale was used to measure HA. Sociodemographic factors included age, sex, education, household income, quality of friendship and participation in an organized activity.

HA showed an exponential distribution among the participants with a median score of 2 points out of 24 points. In total, 75% had a total score of 5 points or less, whereas 1% had a score >14 points. Education, household income, quality of friendship and participation in organized activity were significantly associated with HA. The variable quality of friendship demonstrated the strongest association with HA.

Our study showed an exponential distribution of HA in a general adult population. There was no evident cut-off point to distinguish participants with severe HA based on their WI-6 score, indicating the importance of analysing HA as a complex, continuous construct. HA demonstrated strong associations with quality of friendship and participation in an organized activity.