Do patients with pathological health anxiety fear COVID-19? A time-course analysis of 12 single cases during the "first wave" of the COVID-19 pandemic in Germany

Karoline S Sauer; Andrea Schmidt; Stefanie M Jungmann; Josef Bailer; Michael Witthöft

doi:10.1016/j.jpsychores.2021.110687

Do patients with pathological health anxiety fear COVID-19? A time-course analysis of 12 single cases during the "first wave" of the COVID-19 pandemic in Germany

J Psychosom Res. 2021 Dec 1:152:110687. doi: 10.1016/j.jpsychores.2021.110687. Online ahead of print.

Authors

Karoline S Sauer¹, Andrea Schmidt², Stefanie M Jungmann³, Josef Bailer⁴, Michael Witthöft⁵

Affiliations

¹ Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Germany. Electronic address: karsauer@uni-mainz.de.
² DIPF | Leibniz Institute for Research and Information in Education, Germany. Electronic address: andrea.schmidt@dipf.de.
³ Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Germany. Electronic address: jungmann@uni-mainz.de.
⁴ Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Germany. Electronic address: josef.bailer@zi-mannheim.de.
⁵ Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Germany. Electronic address: witthoef@uni-mainz.de.

Abstract

Objective: Pre-existing health anxiety is associated with an intensified affective response to the novel COVID-19 pandemic in the general population. Still, results on the reaction of people with a diagnosis of pathological health anxiety (i.e., hypochondriasis) are scarce.

Methods: In the present study, we investigated the course of (health) anxiety related to SARS-CoV-2/COVID-19 in comparison to (health) anxiety related to other severe diseases (e.g., cancer) in a sample of 12 patients with the diagnosis of pathological health anxiety during the "first wave" of the COVID-19 pandemic in Germany. Both SARS-CoV-2 related anxiety and anxiety related to other severe diseases were assessed weekly over 16 measurement points (30.03.-19.07.2020) and primarily analyzed with fixed effects regression analyses.

Results: Unexpectedly, SARS-CoV-2 related anxiety was on average significantly lower than anxiety related to other severe diseases (d = -0.54, p < .001) and not significantly associated with anxiety related to other severe diseases or pre-COVID-19 health anxiety.

Conclusion: It therefore appears premature to assume that SARS-CoV-2 related anxiety and other health worries are necessarily strongly interrelated and comparably high in people with pathological health anxiety.

Keywords: COVID-19; Health anxiety; Hypochondriasis; SARS-CoV-2; Virus anxiety.