Internet-based cognitive–behavioural therapy for severe health anxiety: randomised controlled trial

TLDR

Hypochondriasis is a common severe health‑anxiety disorder that causes functional disability, and although CBT is effective, it is not widely available. The study aimed to evaluate the efficacy of internet‑based CBT for hypochondriasis. A randomized superiority trial compared 12‑week internet‑based CBT (n = 40) with an attention‑control group (n = 41), using the Health Anxiety Inventory as the primary outcome. Participants receiving internet‑based CBT showed large, superior improvements in health anxiety (Cohen’s d 1.52–1.62) versus controls. The trial is registered at ClinicalTrials.gov (NCT00828152).

Abstract

Background Hypochondriasis, characterised by severe health anxiety, is a common condition associated with functional disability. Cognitive–behavioural therapy (CBT) is an effective but not widely disseminated treatment for hypochondriasis. Internet-based CBT, including guidance in the form of minimal therapist contact via email, could be a more accessible treatment, but no study has investigated internet-based CBT for hypochondriasis. Aims To investigate the efficacy of internet-based CBT for hypochondriasis. Method A randomised controlled superiority trial with masked assessment comparing internet-based CBT ( n = 40) over 12 weeks with an attention control condition ( n = 41) for people with hypochondriasis. The primary outcome measure was the Health Anxiety Inventory. This trial is registrated with ClinicalTrials.gov (NCT00828152). Results Participants receiving internet-based CBT made large and superior improvements compared with the control group on measures of health anxiety (between-group Cohen's d range 1.52–1.62). Conclusions Internet-based CBT is an efficacious treatment for hypochondriasis that has the potential to increase accessibility and availability of CBT for hypochodriasis.