CBT for Health Anxiety: A Meta-Analysis of Treatment Outcome and Moderators

The present investigation employed meta-analysis to examine the efficacy of cognitive-behavioral therapy (CBT) for hypochondriasis/health anxiety as well as potential moderators that may be associated with outcome. A literature search revealed 15 comparisons among 13 randomized-controlled trials (RCTs) with a total sample size of 1081 participants that met inclusion criteria. Results indicated that CBT outperformed control conditions on primary outcome measures at post-treatment (Hedges’s g = 0.95) and at follow-up (Hedges’s g = 0.34). CBT also outperformed control conditions on measures of depression at post-treatment (Hedges’s g = 0.64) and at follow-up (Hedges’s g = 0.35). Moderator analyses revealed that higher pre-treatment severity of hypochondriasis/health anxiety was associated with greater effect sizes at follow-up visits and depression symptom severity was significantly associated with a lower in effect sizes at post-treatment. Although effect size did not vary as a function of blind assessment, smaller effect sizes were observed for CBT vs. treatment as usual control conditions than for CBT vs. waitlist control. A dose response relationship was also observed, such that a greater number of CBT sessions was associated with larger effect sizes at post-treatment. This review indicates that CBT is efficacious in the treatment of hypochondriasis/health anxiety and identifies potential moderators that are associated with outcome. The implications of these findings for further delineating prognostic and prescriptive indicators of CBT for hypochondriasis/health anxiety are discussed.

Olatunji, B. O., Kauffman, B. Y., Meltzer, S., Davis, M. L., Smits, J. A. J., & Powers, M. B. (July 01, 2014). Cognitive-behavioral therapy for hypochondriasis/health anxiety: A meta-analysis of treatment outcome and moderators. Behaviour Research and Therapy, 58, 10, 65-74.

CBT is Effective for Health Anxiety in Medical Settings

According to a recent study published in the Lancet, researchers have discovered that a short course of cognitive behavior therapy (CBT) may be an effective and inexpensive method of reducing health anxiety among patients in medical clinics. The Cognitive Behaviour Therapy for Health Anxiety in Medical Patients (CHAMP) study included 444 participants with health anxiety who were attending different medical clinics across six UK hospitals. Participants were randomly assigned to receive either 5 to 10 sessions of CBT (n=219) or standard care (n=225). After one year, twice as many patients in the CBT group reached normal levels of health anxiety.  These improvements were sustained for 2 years, and there was no significant cost difference between the two groups. These findings suggest that a wider application of CBT in medical care may be beneficial to patients in medical settings.

Tyrer, P., Cooper, S., Salkovskis, P., Tyrer, H., Crawford, M., Byford, S., Dupont, S., … McLaren, E. (2014). Clinical and cost-effectiveness of cognitive behaviour therapy for health anxiety in medical patients: a multicentre randomised controlled trial.The Lancet, 383, 9913, 219-225.

Self-Focus in Cognitive Therapy

In this video from a recent Beck Institute Workshop, Dr. Aaron Beck discusses self-focus in Cognitive Therapy. Dr. Beck states that psychological disorders often involve some degree of self-focus. With health anxiety, for example, an over-focus on sensations in the body trigger irrational thoughts and beliefs. As patients become fixated on their bodily sensations, thoughts, and beliefs, their symptoms exacerbate. Mindfulness is one technique patients can use to help control their focus and distance themselves from fixations.

For CBT resources, visit Beck Institute’s CBT Store.