Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
J Psychosom Res. 2017 Dec;103:9-14. doi: 10.1016/j.jpsychores.2017.09.013. Epub 2017 Sep 28.
Self-rated health (SRH) has been shown to be a stable predictor of illness and mortality. Improvement in SRH, even in the absence of change in objective health, predicts better health and reduced mortality. Severe health anxiety (SHA) is characterized by fear of illness and distorted health perception. The objective of the present study was to investigate if exposure-based cognitive behavior therapy (CBT) for SHA can lead to improvement in SRH and whether this improvement is mediated by reduced health anxiety.
Data were collected from a randomized controlled trial where participants with SHA were allocated to 12weeks of exposure-based CBT (n=99) for SHA or to a no treatment control condition (n=33). The mediation analysis was based on SRH- and health anxiety data collected weekly during the treatment phase.
Linear mixed effects models analysis showed a significant interaction effect of group and time indicating superior improvements in SRH in exposure-based CBT compared to the control condition (Z=2.69, p=0.007). The controlled effect size was moderately large (d=0.64) and improvements were stable at 1-year follow-up. Reduced health anxiety was a significant mediator of improvement in SRH.
12weeks of exposure-based CBT for SHA can lead to significant improvements in SRH. Considering the previously established importance of SRH as a predictor for disease and mortality, exposure-based CBT for severe health anxiety may lead to improvements on several important health parameters, possibly even increasing the likelihood of longevity.
自我报告的健康状况（SRH）已被证明是疾病和死亡率的稳定预测指标。即使客观健康状况没有变化，SRH 的改善也预示着更好的健康和更低的死亡率。严重的健康焦虑（SHA）的特征是对疾病的恐惧和对健康感知的扭曲。本研究的目的是调查基于暴露的认知行为疗法（CBT）治疗 SHA 是否能改善 SRH，以及这种改善是否通过降低健康焦虑来实现。
数据来自一项随机对照试验，其中 SHA 患者被分配到 12 周的基于暴露的 CBT（n=99）治疗 SHA 或不治疗对照条件（n=33）。中介分析基于在治疗阶段每周收集的 SRH 和健康焦虑数据。
线性混合效应模型分析显示，组间和时间的交互效应显著，表明基于暴露的 CBT 组的 SRH 改善明显优于对照组（Z=2.69，p=0.007）。控制后的效应大小为中等（d=0.64），且在 1 年随访时仍保持稳定。健康焦虑的降低是 SRH 改善的一个显著中介因素。
12 周的 SHA 基于暴露的 CBT 可以显著改善 SRH。考虑到 SRH 作为疾病和死亡率的预测指标的重要性，SHA 的基于暴露的 CBT 可能会改善几个重要的健康参数，甚至可能增加长寿的可能性。
