A community-based epidemiological study of health anxiety and generalized anxiety disorder

• Worry about personal health was twice more common among respondents with GAD than those without.
• The inclusion of personal health worry in the DSM-V is appropriate.
• GAD respondents with high health anxiety were significantly older, less educated, and had lower family income.
• High health anxiety increased depressive episode occurrence, domains of worries, GAD symptoms, and service use.
• A high level of health anxiety in GAD may signify a more severe form of the disorder.

This community-based study examined the frequency of worry about personal health in respondents with and without generalized anxiety disorder (GAD), and the impact of health anxiety on the disorder. A random community-based telephone survey of 5118 Chinese respondents aged 18–64 was conducted. A fully structured questionnaire covered the DSM-IV-TR criteria of GAD, major depressive episode (MDE), eight domains of worry, the seven-item Whiteley Index (WI-7), health service use, and socio-demographic information. Worry about personal health ranked fifth (75.6%) among eight domains of worries examined. GAD respondents with high level of health anxiety were significantly older, less educated, and had lower family income. High health anxiety significantly increased the occurrence of one-year MDE, previous persistent worry, previous persistent low mood, number of domains of worries, number of non-core DSM-IV-TR GAD symptoms, health service use, and mistrust of doctors. Health anxiety is common in GAD and may signify greater severity of the disorder.