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Accurate estimates are difficult however it has been estimated that between 30 80 of patients consult physicians for symptoms for which there is no physical basis Hypochondriasis is estimated at approximately 1 2 of the population based on primary care clinics and as many as 20 of people in medical clinics are found to have health anxiety Tyrer et al 2011 Linking this to client Sally it can be seen how she would have contributed 30 80 of patients presenting in primary care with symptoms for which there is little or no evidence of physical health problems Hypochondriasis is presently classified as illness anxiety or somatoform disorder and until recently the treatment of this was not considered to be an important separate issue and classed as being secondary to depression or anxiety For instance Kenyon s influential study of patients with hypochondriacal views found that hypochondriasis was been regarded as secondary to another primary disorder such as depression However with client Sally her focus of treatment as requested by her is the hypochondriasis or IA be the main focus of treatment as it causes her the most distress and for her the anxiety and depressive aspects as products of the IA This approach has been beneficial to Sally because as her IA reduced it was seen to have a positive affect on her mood and general anxiety as captured in the questionnaires PHQ 9 and GAD 7 Hence studies have highlighted that a primary disorder in which false concerns about health are identified as the main problem the affective symptoms such as depression are found to be secondary Bianchi 1971
