Hostname: page-component-7479d7b7d-767nl Total loading time: 0 Render date: 2024-07-13T10:28:45.690Z Has data issue: false hasContentIssue false

Two psychological treatments for hypochondriasis

A randomised controlled trial

Published online by Cambridge University Press:  03 January 2018

David M. Clark
Affiliation:
Department of Psychiatry, University of Oxford
Paul M. Salkovskis
Affiliation:
Department of Psychiatry, University of Oxford
Ann Hackmann
Affiliation:
Department of Psychiatry, University of Oxford
Adrian Wells
Affiliation:
University of Manchester, Manchester Royal Infirmary
Melanie Fennell
Affiliation:
Department of Psychiatry, University of Oxford
John Ludgate
Affiliation:
Department of Psychiatry, University of Oxford
Sameena Ahmad
Affiliation:
Department of Psychiatry, University of Oxford
H. Candida Richards
Affiliation:
Department of Psychiatry, University of Oxford
Michael Gelder
Affiliation:
Department of Psychiatry, University of Oxford

Abstract

Background

Hypochondriasis is generally considered difficult to manage. This study aimed to assess the effectiveness of cognitive therapy and to compare it with an equally credible, alternative treatment.

Method

Forty-eight patients with hypochondriasis were initially randomly assigned to either cognitive therapy, behavioural stress management or a no treatment waiting list control group. At the end of the waiting period, patients in the control group were randomly assigned to one of the two treatments. Assessments were at pre-, mid- and post-treatment or waiting list and at three-, six- and 12-month post-treatment follow-up.

Results

Comparisons with the waiting list group showed both treatments were effective. Comparisons between the treatments showed that cognitive therapy was more effective than behavioural stress management on measures of hypochondriasis, but not general mood disturbance at mid-treatment and at post-treatment. One year after treatment patients who had received either treatment remained significantly better than before treatment, and on almost all measures the two therapies did not differ from each other.

Conclusions

Cognitive therapy is a specific treatment for hypochondriasis. Behavioural stress management is also effective but its specificity remains to be demonstrated.

Type
Papers
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Avia, M. D. Ruiz, M. A. Olivares, M. E. et al (1996) The meaning of psychological symptoms: effectiveness of a group intervention with hypochondriacal patients. Behaviour Research and Therapy, 34, 2331.CrossRefGoogle ScholarPubMed
Barsky, A. J. Wyshak, G. Klerman, G. L. et al (1990) The prevalence of hypochondriasis in medical outpatients. Social Psychiatry and Psychiatric Epidemiology, 25, 8994.CrossRefGoogle ScholarPubMed
Beck, A. T. Rusk, A. J. Shaw, B. F. et al (1979) Cognitive Therapy of Depression. New York: Guilford Press.Google Scholar
Beck, A. T. Epstein, N. Brown, G. et al (1988) An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893897.CrossRefGoogle ScholarPubMed
Borkovec, T. D. & Nau, S. D. (1972) Credibility of analogue therapy rationales. Journal of Behaviour Therapy and Experimental Psychiatry, 3, 257260.CrossRefGoogle Scholar
Borkovec, T. D. Wilkinson, L. Folensbee, R. et al (1983) Stimulus control applications to the treatment of worry. Behaviour Research and Therapy, 21, 247251.CrossRefGoogle Scholar
Clark, D. M. (1988) Applied relaxation: a new look at an old technique. Scandinavian Journal of Behavior Therapy, 17, 7982.Google Scholar
DeLongis, A. Coyne, J. C. Dakof, G. et al (1982) The relationships of daily hassles, uplifts, and major life events to health status. Health Psychology, 1, 119136.CrossRefGoogle Scholar
Hamilton, M. (1959) The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 5055.CrossRefGoogle ScholarPubMed
Hawton, K. & Kirk, J. (1989) Problem-solving. In Cognitive Therapy for Psychiatric Problems: A Practical Guide (eds Hawton, K. Salkovskis, P. M. Kirk, J. et al). Oxford: Oxford University Press.Google Scholar
Kanner, A. D. Coyne, J. C. Schaefer, C. et al (1981) Comparison of two modes of stress measurement: daily hassles and uplifts versus major life events. Journal of Behavioural Medicine, 4, 139.Google Scholar
Kellner, R. (1985) Functional somatic symptoms and hypochondriasis: A survey of empirical studies. Archives of General Psychiatry, 42, 821833.CrossRefGoogle ScholarPubMed
Öst, L. G. (1987) Applied relaxation: Description of a coping technique and review of controlled studies. Behaviour Research and Therapy, 23, 397409.CrossRefGoogle Scholar
Salkovskis, P. M. (1989) Somatic problems. In Cognitive Therapy for Psychiatric Problems: A Practical Guide (eds Hawton, K. Salkovskis, P. M. Kirk, J. et al). Oxford: Oxford University Press.Google Scholar
Spitzer, R. L. & Williams, J. B. (1986) Structured Clinical Interview for DSM–III–R. New York: New York State Psychiatric Institute.Google Scholar
Warwick, H. M. C. & Salkovskis, P. M. (1990) Hypochondriasis. Behaviour Research and Therapy, 28, 105117.CrossRefGoogle ScholarPubMed
Warwick, H. M. C. Clark, D. M. Cobb, A. M. et al (1996) A controlled trial of cognitive–behavioural treatment of hypochondriasis. British Journal of Psychiatry, 169, 189195.Google Scholar
Wells, A. & Hackmann, A. (1993) Imagery and core beliefs in health anxiety: Content and origins. Behavioural and Cognitive Psychotherapy, 21, 265273.CrossRefGoogle Scholar
Wells, A. & Matthews, G. (1994) Attention and Emotion. Hove: Lawrence Erlbaum.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.