Psychological and behavioral correlates of health anxiety and other anxiety phenomena in adolescence—A cross-sectional study in the Copenhagen Child Cohort 2000

Abstract

Background: Health anxiety (HA) is characterized by impairing worry about being or becoming seriously ill. This cross-sectional study aimed to explore psychological and behavioral correlates of HA compared to other anxiety phenomena in adolescents, that is, with respect to depression, physical symptoms, bodily dissatisfaction, health-related quality of life (HRQoL) and healthcare utilization. Methods: This study was pre-registered at https://doi.org/10.17605/OSF.IO/YNBJG. We employed data from the 16/17-year follow-up (N = 2438, 16/17 years old) from the general population-based Copenhagen Child Cohort 2000. Health anxiety, anxiety, depression, physical symptoms, bodily dissatisfaction, and HRQoL were assessed using self-report questionnaires, and linked to register data on healthcare utilization. Latent profile and latent class analyses were applied to explore if specific HA related profiles/classes could be detected. These analyses did not support the idea of HA being independent of other anxieties. Instead, four groups were created based on levels of HA and anxiety symptoms. Differences between the four groups regarding the various health-related aspects were examined using relevant statistics. Results: The four groups were: no anxieties (N = 1822; 74.7%), high other anxiety (N = 364; 14.9%), high HA (N = 111; 4.6%), and both high HA and other anxiety (N = 141; 5.8%). The high HA group reported fewer depressive symptoms, more physical symptoms, and higher healthcare utilization than those with high other anxiety. Compared to those without anxieties, both HA groups had worse scores on all psychological and behavioral correlates. Adolescents with both high HA and other anxiety symptoms reported most depressive and physical symptoms, highest bodily dissatisfaction, the lowest HRQoL and the highest healthcare utilization. Conclusion: HA symptoms often co-occur with additional anxiety symptoms but is specifically associated with significantly higher healthcare utilization, highlighting the importance of early recognition and intervention in youth to reduce its clinical impact.