The mechanisms underlying improvement in hypochondriasis are examined in a study published in the current issue of Psychotherapy and Psychosomatics. Cognitive-behavioral therapy (CBT) has been shown previously to be beneficial in the treatment of hypochondriasis. In the current study, the investigators sought to determine whether there was a differential treatment effect for patients with greater levels of anxiety at the outset of treatment.
A total of 182 hypochondriacal participants (139 women, mean = 42.1 years of age) were randomly assigned to a CBT or control group. All participants completed self-report measures of hypochondriasis that exceeded a predetermined threshold on 2 successive occasions (inclusion criteria). CBT consisted of 6 weekly, 90-min sessions. The control subjects received the usual medical care during the same period.
Three questionnaires (Whiteley Index, Health Anxiety Inventory, and Somatic Symptom Inventory) were used to assess hypochondriacal symptoms, and the Symptom Checklist 90R was used to assess anxiety and other psychological symptoms. These were administered before the intervention and at 6 and 12 months after the completion of the intervention.
Scores on the 3 measures of hypochondriasis were significantly decreased after treatment in the CBT compared with the control group. Anxiety and other psychological symptoms also showed significant reductions in the CBT group. High levels of pretreatment anxiety predicted decreases in the 3 hypochondriasis scores after controlling for the effects of depression, age, sex, educational level, employment status, and marital status. In short, high anxiety at entry into the CBT program predicted a better treatment outcome.
Material adapted from Journal of Psychotherapy and Psychosomatics
Nakao, M. ; Shinozaki, Y. ; Ahern, D.K. ; Barsky, A.J. Anxiety as a Predictor of Improvements in Somatic Symptoms and Health Anxiety Associated with Cognitive-Behavioral Intervention in Hypochondriasis. Psychother Psychosom 2011;80:151-158.