Cognitive behaviour therapy exerts durable effects on hypochondriasis

Cognitive behaviour therapy appears to be effective in the long-term treatment of pathological health anxiety, also known as hypochondriasis, as shown in a study. In contrast, standard care may promote depression.

The study included 444 patients aged 16–75 years seen in cardiology, endocrinology, gastroenterology, neurology, and respiratory medicine clinics. They were randomized to undergo cognitive behaviour therapy adapted for health anxiety (CBT-HA, six sessions in total) or to receive standard care.

Of the patients, 306 (68.9 percent) completed the 8-year follow-up, including 36 who had died. The primary outcome was a change in Short Health Anxiety Inventory (HAI) score. Generalized anxiety and depression were also evaluated as secondary outcomes.

Over 8 years of follow-up, patients in the CBT-HA showed a greater improvement in their HAI scores compared with those who received standard care (difference, 1.83, 95 percent confidence interval [CI] 0.25–3.40; p=0.023).

CBT-HA also proved to be more effective than standard care in terms of depression (difference, 1.22, 95 percent CI, 0.42–2.01; p<0.003). Of note, most patients in the standard care group met the criteria for clinical depression. Meanwhile, there was no significant between-group difference noted for generalized anxiety (difference, 0.54, 95 percent CI, −0.29 to 1.36; p=0.20).

Patients seen by nurse therapists and in cardiology and gastrointestinal clinics achieved the greatest gains with CBT-HA, with substantial improvements in both symptoms and social function.