Continuity of health anxiety from childhood to adolescence and associated healthcare costs: a prospective population‐based cohort study
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Background: Severe health anxiety (HA) is characterized by excessive and impairing worry and preoccupation with health issues and can cause increased and unnecessary medical examinations. HA in childhood and adolescence is scarcely explored, hindering the potential for prevention and early intervention. Methods: HA was assessed in 1,278 children/youths at two time points at ages 11 and 16 years in a general population‐based birth cohort. Register‐based data on costs related to nonhospital‐based primary and secondary somatic health services were obtained over the follow‐up period. The presence of functional somatic symptoms, emotional disorders and chronic somatic illness at baseline were included as covariates. Results: High HA (top 10% score) at age 11 predicted high HA at age 16 (relative risk [RR] 2.03, 95% CI: 1.26–3.31). The group with persistent HA was small ( n = 17, 1.3%), resulting in broad confidence intervals. The statistical effect of HA at age 11 on HA at age 16 was heavily reduced after adjustment for sex and all covariates (RR: 1.49, 95% CI: 0.85–2.60). In the adjusted model, somatic illness at age 11 (RR: 1.91, 95% CI: 1.22–2.98) and female sex (RR: 3.33, 95% CI: 2.01–5.50) were independently associated with HA at age 16. Persistent HA was associated with approximately doubled healthcare costs compared to the group with consistently low HA. Incident HA at age 16 was associated with increased costs over follow‐up. The increased costs were not explained by chronic somatic illness. Conclusions: A small subgroup of children had persistent high levels of HA from late childhood to adolescence and displayed increased healthcare costs. Female sex and chronic somatic disorders at age 11 were independent risk factors of HA at age 16. These findings provide potential means of early identification and of therapeutic levers. Further intervention development and evaluation are needed.
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Cross-sectional studies have shown that children and adolescents can experience severe health anxiety as assessed using dimensional measures.
“Cross-sectional studies have shown that children and adolescents can experience severe health anxiety as assessed using dimensional measures [89, 90].”
From Illness Anxiety Disorder: A Review of the Current Research and Future Directions (2024) · cites this paper as [89]
The Child and adolescent interviews section describes dimensional health-anxiety scales used at ages 11 and 16, and the Results report children with high scores at each age. The paper is a prospective cohort study, however, and its high-score groups do not establish that those children had clinically severe health anxiety. No page numbers are available in our copy. (LLM, conf=0.82)
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Self-citation
- Authors
- Rimvall, M. K., Jeppesen, P., Skovgaard, A. M., Verhulst, F., Olsen, E. M., & Rask, C. U.
- Affiliations
- University of Copenhagen (DK)
- University of Southern Denmark (DK)
- Aarhus University (DK)
- Corresponding author
- Rimvall, Martin K.
- ORCID
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2020-06-25
- Volume
- 62
- Issue
- 4
- Pages
- 441-448
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W3037464542
- Cited by
- 22
- References
- 40
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 9 · 2023: 4 · 2021: 4 · 2020: 1
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- University of Southern Denmark Research Portal (University of Southern Denmark) (acceptedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Funders
- TrygFonden (109903, 7‐10‐0189, 7‐11‐0341)
- Lundbeckfonden (R54‐A5843)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- health anxiety, adolescence, health care costs, functional somatic symptoms, sex differences, early detection, risk factors
- MeSH terms
- Adolescent, Anxiety, Anxiety Disorders, Child, Female, Humans, Prospective Studies, Cohort Studies, Health Care Costs
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