The diagnosis of hypochondria has disappeared in the new classification of mental illness. About 25% of patients who were diagnosed with hypochondria now fall into the category illness anxiety disorder. This disorder constitutes a new diagnostic category in DSM5 and is included within the somatic symptom and related disorders.

We propose to carry out a bibliographic review off the new diagnostic category of illness anxiety disorder.

We present the clinical case of a 27-year-old man in the context of the Covid19 pandemic.

The illness anxiety disorder is characterized by being concerned about having or acquiring a serious illness. Somatic symptoms are not present, but if they are, they are of mild intensity. The level of concern is excessive or disproportionate if there is any disease or if there is a high risk of developing it. There is a high level of health anxiety and the individual is easily alarmed by personal health status. It is a disorder that tends to be chronic and recurrent. The exact comorbidity is still unknown. However, it is important to keep in mind that hypochondria concurs with anxiety disorders and depressive disorders. Treatment is based on the cognitive restructuring of bodily symptoms. In addition, exposure therapy and acceptance and commitment therapy are also effective. Regarding pharmacological treatment, SSRIs are useful in relation with comorbidity.

Illness anxiety disorder is characterized by significant attention to somatic concerns in medical places, making it very useful for primary care professionals.

The prevalence and severity of neurocognitive dysfunctioning of patients with somatic symptom and related disorders (SSRD) is unknown. Furthermore, the influence of comorbid depression and anxiety has not been evaluated. This study examines neurocognitive dysfunctioning of patients with SSRD and explores if comorbid depression and anxiety is associated with specific neurocognitive dysfunctioning.

Cross-sectional study with consecutive patients suffering from SSRD visiting an outpatient specialty mental health care Centre of Excellence for SSRD. Extensive neuropsychological assessment and assessment of depression and anxiety symptom levels using the Patient-Health-Questionnaire-9 and General Anxiety Disorder questionnaire-7 were performed at intake. Multivariate analysis was performed.

The study sample consisted of 201 SSRD patients, with a mean age of 43 years (Standard deviation = 13) years; 37.8% were male. Neurocognitive dysfunction in the domains information processing speed, sustained and divided attention, working memory, verbal and visual memory were reported, compared with normative data. Comorbid depression and anxiety occurred frequently within the sample (75.1% and 65.7%, respectively). Neurocognitive dysfunctioning was worse in patients suffering from comorbid depression [multivariate F (7,161) = 2.839, p = 0.008] but not in patients with comorbid anxiety.

Poor neurocognitive performance of patients with SSRD is common and worsens in case of comorbid depression. This may explain treatment dropout of patients with SSRD from neurocognitive behavioral therapy. Research on novel interventions is needed targeting neurocognitive functioning of patients with SSRD, particularly those with comorbid depression.