Anxiety as a predictor of improvements in somatic symptoms and health anxiety associated with cognitive-behavioral intervention in hypochondriasis.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

High anxiety at entry into the CBT program predicted a better treatment outcome.