skip to main content

Illness anxiety disorder — RACGP Fellowship MCQ

Instant feedback + full explanation. One question, done properly.

HardMental healthIllness anxiety disorderRACGP Fellowship

A 37‑year‑old man attends his sixth appointment in three months convinced he has pancreatic cancer. He reports intermittent mild abdominal discomfort. Examination is unremarkable. Previous investigations—including FBC, LFTs, and abdominal ultrasound—are normal. There has been no weight loss. Reassurance provides only brief relief before he again requests further testing. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Acknowledge his distress, set limits on further investigations, and offer cognitive behavioural therapy

Explanation lettering: D = shown as A · E = shown as B · B = shown as D · A = shown as E

This presentation is most consistent with illness anxiety disorder: persistent fears of serious illness despite normal findings and transient relief after reassurance. Reassurance‑seeking perpetuates anxiety. Guidelines clearly support psychological management—particularly CBT—as the first‑line intervention for anxiety disorders in general practice, alongside setting firm limits on low‑yield investigations. Imaging or tumour markers (Options B and C) reinforce anxiety and risk iatrogenic harm. Opioid analgesia (Option D) is inappropriate for mild symptoms and carries risks. Dismissing symptoms as ‘imaginary’ (Option E) damages trust and therapeutic alliance. Option A offers an empathic, evidence‑based therapeutic plan aligned with Australian practice.

Reference: Anxiety disorders – assessment and management in general practice; e‑Mental health for mood and anxiety disorders in general practice (RACGP), both endorse CBT as the first‑line treatment for anxiety disorders.