Division of Psychosomatic Medicine, Teikyo University Hospital, Tokyo, Japan.
Psychother Psychosom. 2011;80(3):151-8. doi: 10.1159/000320122. Epub 2011 Mar 3.
Cognitive-behavioral therapy (CBT) has been shown to be beneficial in the treatment of hypochondriasis. In this study, we 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. CBT consisted of 6, weekly 90-min sessions. The control subjects received the usual medical care during the same period. Three questionnaires (the Whiteley Index, the Health Anxiety Inventory, and the 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.
High anxiety at entry into the CBT program predicted a better treatment outcome.
认知行为疗法（CBT）已被证明对疑病症的治疗有益。在这项研究中，我们试图确定在治疗开始时焦虑程度较高的患者是否存在差异治疗效果。
共有 182 名疑病症患者（女性 139 名，平均年龄为 42.1 岁）被随机分配到 CBT 或对照组。所有参与者都完成了两次连续超过预定阈值的疑病症自我报告测量。CBT 包括 6 次，每周 90 分钟的课程。对照组在同一时期接受了常规医疗护理。使用三个问卷（Whiteley 指数、健康焦虑量表和躯体症状清单）来评估疑病症症状，使用症状检查表 90R 来评估焦虑和其他心理症状。这些问卷在干预前和干预完成后 6 个月和 12 个月进行评估。
与对照组相比，CBT 组治疗后 3 种疑病症测量的得分显著降低。CBT 组的焦虑和其他心理症状也明显减少。在控制抑郁、年龄、性别、教育水平、就业状况和婚姻状况的影响后，治疗前高水平的焦虑预测了 3 种疑病症评分的降低。
进入 CBT 项目时的高焦虑水平预示着更好的治疗效果。
