Health anxiety as a continuous construct in the general population - measuring the distribution of health anxiety and the associations with healthcare use, physical disease and cardiovascular risk factors

• Main Author: Norbye, Anja Margrete Davis
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: UiT The Arctic University of Norway 2022
• Subjects: VDP::Medical disciplines: 700::Health sciences: 800::Community medicine; Social medicine: 801; VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin; sosialmedisin: 801; VDP::Medical disciplines: 700::Health sciences: 800::Epidemiology medical and dental statistics: 803; VDP::Medisinske Fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803; VDP::Medical disciplines: 700::Health sciences: 800::Health service and health administration research: 806; VDP::Medisinske Fag: 700::Helsefag: 800::Helsetjeneste- og helseadministrasjonsforskning: 806; VDP::Social science: 200::Psychology: 260::Other psychology disciplines: 279; VDP::Samfunnsvitenskap: 200::Psykologi: 260::Andre psykologiske fag: 279; Tromsøundersøkelsen; The Tromsø Study; DOKTOR-003; Tromsø
• Online Access: https://hdl.handle.net/10037/27090

Background: Health anxiety (HA) concerns worry of disease, and has mostly been examined in people with severe HA/hypochondriasis. However, HA can be conceptualised as a continuous construct, with levels ranging from low to severe. There is little knowledge on the distribution of HA as a continuous construct in the general population, nor the association between different levels of HA and healthcare use, physical disease and cardiovascular risk factors. Aim: To study the distribution of HA as a continuous construct in the general population, examine sociodemographic and social network factors associated with HA, and examine the association between HA and healthcare use, physical disease and cardiovascular risk factors. Methods: This thesis used cross-sectional data from the Tromsø study: Tromsø7 (2015-2016). 21 083 persons aged 40 years or older gave self-reported information on physical diseases, cardiovascular risk factors, and healthcare use in the last 12 months. HA was measured with Whiteley Index; possible scores ranged from 0-24. Sociodemographic and social network factors included age, gender, education, household income, friendship, and participation in organised activities. Results: HA was highly skewed in our sample of the general adult population, with an exponential distribution. Of the sociodemographic and social network variables, friendship had the highest association with HA level. HA as a continuous construct was associated with increased level of use of all types of healthcare services. HA was also consistently higher in the population reporting current or previous physical disease and cardiovascular risk factors, than in the healthy reference group. Conclusion: Our results support conceptualising HA as a continuous construct. Mean HA in the study sample was low, but all levels of HA were associated with increased healthcare use. Having physical disease and cardiovascular risk factors were consistently associated with increased HA. This indicates that all levels of HA deserve attention in ...