Health anxiety — eradicate? support? dose?

Background. Health anxiety is considered to be a specific psychological construct, that determines the individual health behavior making a crucial impact on the treatment adherence and prevention strategies. All mentioned above defines its interdisciplinary importance. The task of every medical doctor is to attract patients attention to the necessity of taking care of one’s health using all available professional communication skills. The recent active development of the digital technologies makes a serious impact on the ones information seeking behavior, including medical information search, creating an internal model of the illness and modern health anxiety manifestation highlighting in this article. Digital space and AI creation capable of big data speedy analyzation open for the professional’s new options of social listening. Today we have the opportunity of new evaluation of patient’s treatment choices and their mindset networks development. The accumulated data can be used for the targeted psychosocial interventions development aimed to improve the treatment adherence.

Conclusion. In the internists routine practice there is a high rate of patients with nosogenic anxiety disorders associated with the internal illness model, fear of the disease progress and also with the typical anxiety disorders manifesting in the somatic sphere, nosophobias, hypochondriac states. Their complex treatment should include combination of psychotherapy and pharmacotherapy, where anxiolytics can be considered as the treatment choice.

1. Health Literacy. The solid facts. Eds: Kickbusch I., Pelikan J. M., Apfel F., Tsouros A. D. WHO. Regional office. Accessed 20 September, 2025. https://www.euro.who.int/data/assets/pdf_file/0008/190655/e96854.pdf.

2. Sirota N. A., Yaltonsky V. M., Abrosimov I. N., et al. Clinical psychology of the treatment process. Moscow: GEOTAR-media, 2023. 400 p. (In Russ.)

3. Kalinina A. M., Kulikova M. S., Shepel R. N., Astanina S. Yu., Kontsevaya A. V., Drapkina O. M. Multiple behavioral risk factors for chronic noncommunicable diseases: the concept of concatenated influence. Profilakticheskaya meditsina. 2025; 28 (1): 44-49. (In Russ.) https://doi.org/10.17116/profmed20252801144.

4. Shalnova S. A., Balanova Yu. A., Deev A. D., et al. Integrated assessment of adherence to a healthy lifestyle as a way of monitoring the effectiveness of preventive measures. Profilakticheskaya meditsina. 2018; 21 (4): 65-72. (In Russ.) https://doi.org/10.17116/profmed201821465.

5. Duda-Sikuła M., Kurpas D. Barriers and Facilitators in the Implementation of Prevention Strategies for Chronic Disease Patients-Best Practice GuideLines and Policies' Systematic Review. J Pers Med. 2023; 13 (2): 288. DOI: 10.3390/jpm13020288.

6. Battles J. B., Dixon N. M., Borotkanics R. J., Rabin-Fastmen B., Kaplan H. S. Sensemaking of patient safety risks and hazards. Health Serv Res. 2006; 41 (4 Pt 2): 1555-75. DOI: 10.1111/j.1475-6773.2006.00565.x.

7. Rhodes P., McDonald R., Campbell S., Daker-White G., Sanders C. Sensemaking and the co-production of safety: a qualitative study of primary medical care patients. Sociol Health Illn. 2016; 38 (2): 270-285. DOI: 10.1111/14679566.12368.

8. Weick K. E., Sutcliffe K. M., Obstfeld D. Organizing and the process of sensemaking. Organization Science. 2005; 16 (4): 409-421. https://doi.org/10.1287/orsc.1050.0133.

9. Gabbay J., le May A. Evidence based guidelines or collectively constructed "mindlines?" Ethnographic study of knowledge management in primary care. BMJ. 2004; 329 (7473): 1013. DOI: 10.1136/bmj.329.7473.1013.

10. Kanchan S., Gaidhane A. Social Media Role and its impact on Public Health: a narrative review. Cureus. 2023; 15.

11. Neznanov N. G., Vasileva A. V. Digitalization in mental health care. New opportunities for specialists and patients. Natsionalnoe zdravookhranenie. 2023; 4 (2): 15-24. (In Russ.) https://doi.org/10.47093/2713-069X.2023.4.2.15-24.

12. Moorhead S. A., Hazlett D. E., Harrison L., Carroll J. K., Irwin A., Hoving C. A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication. J Med Internet Res. 2013; 15: 6. 10.2196/JMIR.1933.

13. Farsi D., Martinez-Menchaca H. R., Ahmed M., Farsi N. Social media and health care (part II): narrative review of social media use by patients. J Med Internet Res. 2022; 24: e30379. 10.2196/30379.

14. Mullin A., Scott M., Vaccaro G., Floresta G., Arillotta D., Catalani V., et al. Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present using Analytical and Social listening techniques. Pharm (Basel). 2024; 12: 13.

15. Hu H., Phan N. H., Geller J., Iezzi S., Vo H., Dou D., et al. An Ensemble Deep Learning Model for drug abuse detection in Sparse Twitter-Sphere. Stud Health Technol Inf. 2019; 264: 163-167.

16. Plan d’actions de l’ANSM visant à réduire le mésusage des. benzodiazépines – Point d’information – ANSM: Agence nationale de sécurité du médicament et des produits de santé. https://archiveansm.integra.fr/S-informer/Pointsd-information-Points-d-information/Plan-d-actions-de-l-ANSM-visant-areduire-le-mesusage-des-benzodiazepines-Point-d-information. Accessed 19 Oct. 2025.

17. Van Hulten R., Isacson D., Bakker A., Leufkens H. G. Comparing patterns of long-term benzodiazepine use between a Dutch and a Swedish community. Pharmacoepidemiol Drug Saf. 2003; 12: 49-53.

18. benzo.org.uk: Benzodiazepines: How They Work & How to Withdraw, Prof CH, Ashton DM. FRCP, 2002. https://www.benzo.org.uk/manual/index.htm. Accessed 19 Oct. 2025.

19. Bachhuber M. A., Hennessy S., Cunningham C. O., Starrels J. L. Increasing Benzodiazepine prescriptions and Overdose Mortality in the United States, 1996-2013. Am J Public Health. 2016; 106: 686–688.

20. Sarker A., Al-Garadi M. A., Ge Y., Nataraj N., McGlone L., Jones C. M., et al. Evidence of the emergence of illicit benzodiazepines from online drug forums. Eur J Public Health. 2022; 32: 939.

21. FDA Drug Safety Communication. FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning | FDA. https://www.fda.gov/drugs/drug-safetyand-availability/fda-drug-safety-communication-fda-warns-about-seriousrisks-and-death-when-combining-opioid-pain-or. Accessed 19 Oct. 2025.

22. De Anta L., Alvarez-Mon M. Á., Pereira-Sanchez V., Donat-Vargas C. C., Lara-Abelenda F. J., Arrieta M., Montero-Torres M., García-Montero C., Fraile-Martínez Ó., Mora F., Ortega M. Á., Alvarez-Mon M., Quintero J. Assessment of beliefs and attitudes towards benzodiazepines using machine learning based on social media posts: an observational study. BMC Psychiatry. 2024; 24 (1): 659. DOI: 10.1186/s12888-024-06111-5.

23. Farrar M., Lundt L., Franey E., Yonan C. Patient perspective of tardive dyskinesia: results from a social media listening study. BMC Psychiatry. 2021; 21. 10.1186/S12888-021-03074-9.

24. Chart-Pascual J. P., Goena J., Lara F., Montero Torres M., Marin Napal J., Muñoz R., García Montero C., Fraile Martínez O., Ortega M. Á., Salazar de Pablo G., González Pinto A., Quintero J., Alvarez-Mon M., Álvarez-Mon M. Á. Understanding social media discourse on antidepressants: unsupervised and sentiment analysis using X. Eur Psychiatry. 2025; 68 (1): e51. DOI: 10.1192/j.eurpsy.2025.10.

25. Kisa A., Kisa S. Health conspiracy theories: a scoping review of drivers, impacts, and countermeasures. Int J Equity Health. 2025; 24 (1): 93. DOI: 10.1186/s12939-025-02451-0.

26. Neznanov N. G., Kotsyubinsky A. P., Kotsyubinsky D. A. Cyberpsychiatry is a new approach to understanding the impact of digital information space on the mental health of individuals and society. Report № 1. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V. M. Bekhtereva. 2025; 59 (1): 18-30. (In Russ.) https://doi.org/10.31363/2313-7053-2025-1-984.

27. Lahrach Y., Furnham A. Are modern health worries associated with medical conspiracy theories? J Psychosom Res. 2017; 99: 89-94.

28. Wang D., Zhou Y., Ma F. Opinion Leaders and Structural Hole Spanners Influencing Echo Chambers in Discussions About COVID-19 Vaccines on Social Media in China: Network Analysis. J Med Internet Res. 2022; 24 (11): e40701. DOI: 10.2196/40701.

29. Vasilyev V. V., Mukhametova A. I. Modern researches of personalitypsychological features in patients with somatoform disorders. VObozrenie psikhiatrii i meditsinskoi psikhologii imeni V. M. Bekhtereva. 2024; 58 (1): 30-46. (In Russ.) https://doi.org/10.31363/2313-7053-2024-746.

30. Köteles F., Bárány E., Varsányi P., Bárdos G. Are modern health worries associated with somatosensory amplification, environmental attribution style, and commitment to complementary and alternative medicine? Scand J Psychol. 2012; 53 (2): 144-149. DOI: 10.1111/j.1467-9450.2011.00908.x.

31. Dömötör Z., Nordin S., Witthöft M., Köteles F. Modern health worries: A systematic review. J Psychosom Res. 2019; 124: 109781. DOI: 10.1016/j.jpsychores.2019.109781.

32. Andersen J. H., Jensen J. C. Modern health worries and visits to the general practitioner in a general population sample: an 18month follow-up study. J Psychosom Res. 2012; 73 (4): 264-267. DOI: 10.1016/j.jpsychores.2012.07.007.

33. Kostyuk G. P. Current problems of practical psychiatry: will the new Procedure for providing medical care for mental disorders and behavioral disorders solve them? Natsionalnoe zdravookhranenie. 2023; 4 (1): 48-54. (In Russ.)

34. Vasilyeva A. V., Bogushevskaya Yu. V., Ivchenko A. I. Prognostic assessment of "psychiatristavoidant behavior" in patients with somatization disorders who applied to primary health care institutions. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V. M. Bekhtereva. 2024; 58: 4-1: 61-72. http//doi.org/10.31363/2313-7053-2024-958. (In Russ.)

35. Volel B. A. Nebredovaya ipokhondriya (obzor literatury). Psikhicheskie rasstroistva v obshchei meditsine. 2009; 02: 49-62. (In Russ.)

36. Bogushevskaya Yu. V., Vasileva A. V., Ivchenko A. I. Internal picture of the disease and models of attitude to treatment in women with somatization disorders Konsultativnaya psikhologiya i psikhoterapiya. 2023; 31 (4): 105-124. (In Russ.)

37. Abrosimov I. N., Yaltonsky V. M., Lisitsyna T. A., Abramkin A. A., Lamcheva E. I., Timashkov A. Yu., Lila A. M. Psychological characteristics of patients with rheumatoid arthritis with severe anxiety and depression. Sovremennaya Revmatologiya. 2025; 19 (1): 64-71. DOI: 10.14412/1996-7012-2025-1-64-71.

38. Sirota N. A., Moskochenko D. V. Psychodiagnostics of the fear of disease progression: results of approbation of the Russian-language version of the questionnaire of fear of disease progression. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V. M. Bekhtereva. 2014; 4: 86-91. (In Russ.)

39. Vasileva A. V. Pandemia and mental adjustment disorders. Therapy options. Zhurnal nevrologii i psikhiatrii imeni S. S. Korsakova. 2020; 120 (5): 146-152. (In Russ.) https://doi.org/10.17116/jnevro2020120051146.

40. Astanina S. Yu., Kalinina A. M., Shepel R. N., et al. Communicative skills of a district physician in conducting preventive counseling (methodological aspect). Kardiovaskulyarnaya terapiya i profilaktika. 2023; 22 (1S): 7-14. (In Russ.) https://doi.org/10.15829/1728-8800-2023-3559.

41. Poplavskaya O. V., Tsybulya Yu. V. Modern approaches to the use of Grandaxin (Tofisopam) in the treatment of asthenic conditions. Lekarstvennyi vestnik. 2017; 1 (65), 11. (In Russ.)

42. Pellow S., File S. E. Is tofisopam an atypical anxiolytic? Neurosci Biobehav Rev. 1986; 10 (2): 221-227.

43. Arushanyan E. B., et al. Chronobiological features of the effect of tofisopam on heart rate variability in humans. Eksperimentalnaya i klinicheskaya farmakologiya. 2005; 68 (4): 36-39. (In Russ.)

44. Kokoszka A. A Comparison of the Anxiolytic Properties of Tofisopam and Diazepam: A Double-Blind, Randomized, Crossover, Placebo-Controlled Pilot Study. Pharmaceuticals (Basel). 2024; 17 (1): 140. DOI: 10.3390/ph17010140.

45. Pasechnikov V. D., et al. Correction of psychosomatic disorders in the complex therapy of arterial hypertension in women in the perimenopausal period. Yuzhno-Rossiiskii meditsinskii zhurnal. 2002; 3: 1-4. (In Russ.)

46. Goldin B. G., Savitskaya I. V. Grandaxin in the treatment of anxiety disorders in patients with bronchial asthma. V mire lekarstv. 1999; 3. (In Russ.)

47. Skvortsov G. Yu., Golovacheva T. V. Efficiency of tofisopam (Grandaxin) in the treatment of coronary heart disease: clinical and instrumental confirmation. Klinicheskaya farmakologiya i terapiya. 2001; 1: 52-55. (In Russ.)

48. Vasileva A. V., Karavaeva T. A., Poltorak S. V., Kolesova Y. P. Neurotic level anxiety disorders (panic, generalized anxiety and anxiety-phobic disorders) pschopharmacoceutical treatment principles and algorithms. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V. M. Bekhtereva. 2016; 1: 3-9. (In Russ.)

49. Ronai Sh., Oros F., Bolla K. the use of grandaxine in out-patient setting. Venger Pharmacother. 1975; 4-10. (In Russ.)

50. Alexandorvsky Y. A., Avedisova A. S., Pavlova M. S. The vegetotropic effect of grandaxine in primary care neurotic disorders treatment. Therapevticheskii arkhiv. 1998; 10: 76-85. (In Russ.)

51. Vein A. M., Artemenko A. P., Oknin V. Y., Pomorcev I. V. Grandaxin efficacy in the psychovegetative disorders correction. Klinicheskaya meditsina. 1999; 6: 41-45. (In Russ.)

52. Vasileva A. V., Karavaeva T. A., Semiglazova T. Y. Specific of the psychopharmacotherapy in oncology patients with anxiety disorders. Voprosy onkologii. 2018; 64 (5): 567-661. (In Russ.)