On 3/1, Doctor Nguyen Viet Chung, head of the Mental Health Department at E Hospital, reported that the patient was admitted after numerous prior medical examinations that found no underlying illness. Despite this, she insisted on extensive specialized tests, such as digestive endoscopy and magnetic resonance imaging (MRI), "to be absolutely certain."

The woman has a long history of anxiety disorder spanning several years and has undergone repeated treatments for gastroesophageal reflux disease. She frequently experienced symptoms such as chest burning, nausea, muscle-tension type neck and shoulder pain, palpitations, restlessness, difficulty sleeping, fatigue, and frequent painless urination. These symptoms noticeably intensified since the beginning of the year.

Within approximately 11 months, the patient underwent seven MRI scans across various areas including the brain, cervical spine, and lumbar spine, along with five gastroesophageal endoscopies. All results showed no dangerous lesions. Despite these normal findings, she continued to seek examinations at multiple medical facilities, constantly seeking reassurance and requesting repeated tests.

Doctors concluded that the patient's repeated medical visits were more related to anxiety. Consequently, they declined to order additional tests and referred her to the Psychiatry Department for assessment.

During the initial psychiatric examination, Doctor Chung observed that the patient exhibited health anxiety lasting over six months, frequently fearing serious conditions such as cancer, stroke, or neurological diseases. The patient tended to be overly attentive to minor bodily sensations and continuously sought reassurance from medical staff. Doctors identified stress as a factor exacerbating her reflux and neck and shoulder pain symptoms. The doctor diagnosed the patient with illness anxiety disorder.

According to Doctor Chung, illness anxiety disorder is characterized by patients being overly concerned with their own health. They can easily become obsessed or panic if their body exhibits minor unusual signs, such as localized aches or a gnawing sensation. Even if these symptoms are mild, they perceive them as indicators of a very serious illness, leading them to seek medical attention at various facilities, even when doctors confirm they are not ill.

"The overuse of tests not only fails to reduce anxiety but also creates a cycle of examination, temporary reassurance, and recurrent anxiety," the doctor stated. Therefore, internists must understand the limits of ordering paraclinical tests and collaborate with mental health specialists to treat the underlying nature of the illness, helping patients improve their quality of life and avoid unnecessary medical interventions.

Thuy Quynh.