Hypochondriasis is also known as health anxiety. People with the disorder fear that physical symptoms are signs of serious illness – even if there is no medical evidence that anything is wrong with them. It can be a very debilitating condition, with a risk of unemployment and long-term disability. Research has shown that CBT is effective in treating hypochondriasis, but it is often not available because of its high cost and a shortage of trained therapists.
Researchers from the Karolinska Institutet in Stockholm, Sweden, recruited 81 people who had been diagnosed with hypochondriasis to take part in their study. 40 of the patients received online CBT during a 12-week period. Throughout the treatment, the patients had access to a qualified therapist who provided feedback and support. The other 41 patients acted as the control group, and were given access to an online discussion forum where they could discuss their health anxiety with other patients.
After the 12 weeks, the patients who received internet-based CBT were much less anxious and had fewer depressive symptoms than patients in the control group. Overall, 27 of the 40 patients (67.5%) who received internet-based CBT no longer met the diagnostic criteria for hypochondriasis. In the control group, only 2 of the 41 patients (4.9%) no longer met the criteria. The researchers followed the patients up again after 6 months, and found that the positive effects of online CBT treatment had been maintained.
Lead researcher Erik Hedman said: “Our findings are promising for people with hypochondriasis. The study suggests that this treatment approach is effective in reducing people’s health anxiety, as well as general anxiety and depressive symptoms. Internet-based therapy is cheaper than face-to-face therapy, and can also be delivered more flexibly, meaning it provides an opportunity for dramatically increasing the availability of CBT to people with hypochondriasis.”
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Hedman E, Andersson G, Andersson E, Ljótsson B, Rück C, Asmundson GJG and Lindefors N. Internet-based cognitive-behavioural therapy for severe health anxiety: randomised controlled trial. British Journal of Psychiatry 2011; 198: 230-236