Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom.
J Consult Clin Psychol. 2012 Oct;80(5):817-28. doi: 10.1037/a0028782. Epub 2012 Jun 18.
The efficacy and acceptability of existing psychological interventions for health anxiety (hypochondriasis) are limited. In the current study, the authors aimed to assess the impact of mindfulness-based cognitive therapy (MBCT) on health anxiety by comparing the impact of MBCT in addition to usual services (unrestricted services) with unrestricted services (US) alone.
The 74 participants were randomized to either MBCT in addition to US (n = 36) or US alone (n = 38). Participants were assessed prior to intervention (MBCT or US), immediately following the intervention, and 1 year postintervention. In addition to independent assessments of diagnostic status, standardized self-report measures and assessor ratings of severity and distress associated with the diagnosis of hypochondriasis were used.
In the intention-to-treat (ITT) analysis (N = 74), MBCT participants had significantly lower health anxiety than US participants, both immediately following the intervention (Cohen's d = 0.48) and at 1-year follow-up (d = 0.48). The per-protocol (PP) analysis (n = 68) between groups effect size was d = 0.49 at postintervention and d = 0.62 at 1-year follow-up. Mediational analysis showed that change in mindfulness mediated the group changes in health anxiety symptoms. Significantly fewer participants allocated to MBCT than to US met criteria for the diagnosis of hypochondriasis, both immediately following the intervention period (ITT 50.0% vs. 78.9%; PP 47.1% vs. 78.4%) and at 1-year follow-up (ITT 36.1% vs. 76.3%; PP 28.1% vs. 75.0%).
MBCT may be a useful addition to usual services for patients with health anxiety.
现有的针对健康焦虑（疑病症）的心理干预措施的疗效和可接受性有限。在当前的研究中，作者旨在通过比较正念认知疗法（MBCT）与单纯常规服务（不受限制的服务）对健康焦虑的影响，来评估 MBCT 的影响。
74 名参与者被随机分配到 MBCT 加 US（n = 36）或 US 单独组（n = 38）。参与者在干预前（MBCT 或 US）、干预后立即和干预后 1 年进行评估。除了对诊断状态的独立评估外，还使用了标准化的自我报告量表以及评估者对疑病症诊断相关严重程度和困扰的评分。
在意向治疗（ITT）分析（N = 74）中，MBCT 组的健康焦虑明显低于 US 组，无论是在干预后立即（Cohen's d = 0.48）还是在 1 年随访时（d = 0.48）。两组间的方案分析（n = 68）的组间效应大小为干预后 d = 0.49，1 年随访时 d = 0.62。中介分析显示，正念的变化介导了健康焦虑症状的组间变化。与 US 组相比，接受 MBCT 的参与者符合疑病症诊断标准的人数明显减少，无论是在干预后立即（ITT 50.0%比 78.9%；PP 47.1%比 78.4%）还是在 1 年随访时（ITT 36.1%比 76.3%；PP 28.1%比 75.0%）。
MBCT 可能是健康焦虑患者常规服务的有用补充。
