The British Journal of Psychiatry (2008) 193: 332-337. doi: 10.1192/bjp.bp.108.052936
© 2008 The Royal College of Psychiatrists
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Cognitive–behavioural therapy for health anxiety in a genitourinary medicine clinic: randomised controlled trial

Helen Seivewright, MRCGP, DipGUM

Genitourinary Medicine Clinic, Kings Mill Hospital, Sutton-in-Ashfield, and Department of Psychological Medicine, Division of Neuroscience and Mental Health, Imperial College, London

John Green, PhD

Central North West London Mental Health NHS Trust, London

Paul Salkovskis, PhD, C.Psychol, FBPSS and Barbara Barrett, MSc

Institute of Psychiatry, King's College London

Ula Nur, PhD

Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine

Peter Tyrer, FRCPsych, FMEDSci

Department of Psychological Medicine, Division of Neuroscience and Mental Health, Imperial College, London, UK

Correspondence: Dr Seivewright, Email: h.seivewright{at}imperial.ac.uk

Declaration of interest

P.S. adapted the CBT intervention for health anxiety and developed the Health Anxiety Inventory. P.T. is the Editor of the British Journal of Psychiatry but had no part in the evaluation of this paper for publication. Funding and trial registration detailed in Acknowledgements.

Background

Little is known about the management of health anxiety and hypochondriasis in secondary care settings.

Aims

To determine whether cognitive–behavioural therapy (CBT) along with a supplementary manual was effective in reducing symptoms and health consultations in patients with high health anxiety in a genitourinary medicine clinic.

Method

Patients with high health anxiety were randomly assigned to brief CBT and compared with a control group.

Results

Greater improvement was seen in Health Anxiety Inventory (HAI) scores (primary outcome) in patients treated with CBT (n=23) than in the control group (n=26) (P=0.001). Similar but less marked differences were found for secondary outcomes of generalised anxiety, depression and social function, and there were fewer health service consultations. The CBT intervention resulted in improvements in outcomes alongside higher costs, with an incremental cost of £33 per unit reduction in HAI score.

Conclusions

Cognitive–behavioural therapy for health anxiety within a genitourinary medicine clinic is effective and suggests wider use of this intervention in medical settings.


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