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Illness Fears in the General Population

From the Departments of Psychiatry (C.C.D., R.W.M., R.N., R.L.H.), Family Practice (A.J.H.), and Internal Medicine (C.C.D., R.W.M.), University of Iowa College of Medicine, Iowa City, IA.

Address reprint requests to: Dr. Russell Noyes, Jr., Psychiatry Research, Medical Education Building, Iowa City, IA 52242-1000. Email: rnoyes{at}blue.weeg.uiowa.edu

OBJECTIVES: Because relatively little is known about illness fears, we sought to estimate the prevalence, risk factors, and morbidity associated with such fears in the community.

METHODS: We conducted a brief telephone survey of persons aged 40 to 65 years from randomly selected households in the Johnson County, Iowa, area. Respondents were asked whether a series of illness and medical care items made them no more nervous, somewhat more nervous, or much more nervous than other people. Those who reported more discomfort were asked to what extent this interfered with medical care or caused impairment or distress. Information about demographic and health characteristics was also obtained.

RESULTS: Five hundred persons, 62% of those contacted, responded to the survey. A factor analysis revealed four fear dimensions: illness/injury, medical care, blood/needle, and aging/death. Five percent of respondents reported much more nervousness in relation to at least four of six illness/injury items, 4% indicated that such fears interfered with their medical care, and 5% reported some negative effect on their life. Similarly, 5% of respondents reported much more nervousness in relation to at least two of four medical care items. Illness/injury fears were somewhat more common in persons with lower income and education and in those with medical conditions.

CONCLUSIONS: This survey shows that fears of illness and medical care are common in the general population and indicates that lower socioeconomic status and experience with illness are associated with these fears. The findings also suggest that interference with care occurs among those with the strongest fears.

Key Words: illness fears • phobias • epidemiology • prevalence • risk factors • general population

Abbreviations: DSM-IV = Diagnostic and Statistical Manual of MentalDisorders, 4th ed.

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