Arthur J. Barsky|David K. Ahern
Cognitive Behavior Therapy for Hypochondriasis
Brigham and Women's Hospital|Harvard University|Brigham and Women's Hospital|Harvard University
hypochondriasis chronic distressing disabling condition prevalent ambulatory medical practice recently specific treatment clearly demonstrated effectiveto assess efficacy cognitive behavior therapy cbt hypochondriasisa randomized usual care control group design conducted september 1997 november 2001 individual primary care physician unit randomization patients clustered within physicians practice assigned experimental treatment individual cbt consultation letter primary care physician control condition subjects assessed immediately 6 12 months completion treatmentparticipants 80 patients primary care practices 107 volunteers responding public announcements exceeded predetermined cutoff score hypochondriasis selfreport questionnaire 2 successive occasionsa scripted 6session individual cbt intervention compared medical care usual cbt accompanied consultation letter sent patients primary care physicianhypochondriacal beliefs fears attitudes somatic symptoms role function impairmenta total 102 individuals assigned cbt 85 assigned medical care usual sociodemographic clinical characteristics 2 groups similar baseline using intenttotreat analytic strategy consistent pattern statistically clinically significant treatment effects found 6 12month followup adjusting baseline covariates included educational level generalized psychiatric distress participant status patient vs volunteer 12month followup cbt patients significantly lower levels hypochondriacal symptoms beliefs attitudes p001 healthrelated anxiety p 009 also significantly less impairment social role functioning p 05 intermediate activities daily living p001 hypochondriacal somatic symptoms improved significantly treatmentthis brief individual cbt intervention developed specifically alter hypochondriacal thinking restructure hypochondriacal beliefs appears significant beneficial longterm effects symptoms hypochondriasis