Cognitive behavior therapy for health anxiety: systematic review and meta-analysis of clinical efficacy and health economic outcomes

References

• Sunderland M, Newby JM, Andrews G. Health anxiety in Australia: prevalence, comorbidity, disability and service use. Br J Psychiatry. 2013;202(1):56–61.
   PubMed Web of Science ®Google Scholar
• Tyrer P, Cooper S, Tyrer H, et al. Increase in the prevalence of health anxiety in medical clinics: possible cyberchondria. Int J Soc Psychiatry. 2019;65(7–8):566–569.
   PubMed Web of Science ®Google Scholar
• Fink P, Ørnbøl E, Christensen Sparle K. The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health. PLoS One. 2010;5(3):e9873.
   PubMed Web of Science ®Google Scholar
• Craske MG, Rauch SL, Ursano R, et al. What is an anxiety disorder? Depress Anxiety. 2009;26:1066–1085.
   PubMed Web of Science ®Google Scholar
• Marcus DK, Church SE. Are dysfunctional beliefs about illness unique to hypochondriasis? J Psychosom Res. 2003;54(6):543–547.
   PubMed Web of Science ®Google Scholar
• Neng J, Weck F. Attribution of somatic symptoms in hypochondriasis. Clin Psychol Psychother. 2015;22(2):116–124.
   PubMed Web of Science ®Google Scholar
• Owens KMB, Asmundson GJG, Hadjistavropoulos T, et al. Attentional bias toward illness threat in individuals with elevated health anxiety. Cognit Ther Res. 2004;28(1):57–66.
   Web of Science ®Google Scholar
• Krautwurst S, Gerlach AL, Gomille L, et al. Health anxiety–an indicator of higher interoceptive sensitivity? J Behav Ther Exp Psychiatry. 2014;45(2):303–309.
   PubMed Web of Science ®Google Scholar
• Deacon B, Abramowitz JS. Is hypochondriasis related to obsessive-compulsive disorder, panic disorder, or both? an empirical evaluation. J Cogn Psychother. 2008;22(2):115–127.
   Google Scholar
• Haenen MA, de Jong PJ, Schmidt AJM, et al. Hypochondriacs’ estimation of negative outcomes: domain-specificity and responsiveness to reassuring and alarming information. Behav Res Ther. 2000;38(8):819–833.
   Web of Science ®Google Scholar
• Hedman E, Ljótsson B, Andersson E, et al. Psychometric properties of internet-administered measures of health anxiety: an investigation of the health anxiety inventory, the illness attitude scales, and the whiteley index. J Anxiety Disord. 2015;31:32–37.
   PubMed Web of Science ®Google Scholar
• Abramowitz JS, Moore EL. An experimental analysis of hypochondriasis. Behav Res Ther. 2007;45(3):413–424.
   PubMed Web of Science ®Google Scholar
• Salkovskis PM, Warwick HM. Morbid preoccupations, health anxiety and reassurance: A cognitive-behavioural approach to hypochondriasis. Behav Res Ther. 1986;24(5):597–602.
   PubMed Web of Science ®Google Scholar
• Olatunji BO, Etzel EN, Tomarken AJ, et al. The effects of safety behaviors on health anxiety: an experimental investigation. Behav Res Ther. 2011;49(11):719–728.
   PubMed Web of Science ®Google Scholar
• Weck F, Neng JM, Schwind J, et al. Exposure therapy changes dysfunctional evaluations of somatic symptoms in patients with hypochondriasis (health anxiety). A randomized controlled trial. J Anxiety Disord. 2015;34:1–7.
   PubMed Web of Science ®Google Scholar
• Louw K-A, Hoare J, Stein D. J. Pharmacological treatments for hypochondriasis: a review. Curr Psychiatry Rev. 2014;10(1):70–74.
   Google Scholar
• Walker J, Vincent N, Furer P, et al. Treatment preference in hypochondriasis. J Behav Ther Exp Psychiatry. 1999;30(4):251–258.
   PubMed Web of Science ®Google Scholar
• Furer P, Walker JR. Treatment of hypochondriasis with exposure. J Contemp Psychother. 2005;35(3):251–267.
   Google Scholar
• Bennett-Levy J, Westbrook D, Fennell M, et al. Behavioural experiments: historical and conceptual underpinnings. In: Bennett-Levy J, Butler G, Fennell M, et al., editors. Oxford guide to behavioural experiments in cognitive therapy. Oxford, UK: Oxford University Press; 2004. p. 1–20.
   Google Scholar
• Kroenke K. Efficacy of treatment for somatoform disorders: a review of randomized controlled trials. Psychosom Med. 2007;69(9):881–888.
   PubMed Web of Science ®Google Scholar
• Thomson AB, Page LA. Psychotherapies for hypochondriasis. Cochrane Database Syst Rev. 2007;(4):CD006520.
   PubMed Web of Science ®Google Scholar
• Bouman TK. Psychological treatments for hypochondriasis: a narrative review. Curr Psychiatry Rev. 2014;10(1):58–69.
   Google Scholar
• Olatunji BO, Kauffman BY, Meltzer S, et al. Cognitive-behavioral therapy for hypochondriasis/health anxiety: A meta-analysis of treatment outcome and moderators. Behav Res Ther. 2014;58:65–74.
   PubMed Web of Science ®Google Scholar
• Cooper K, Gregory JD, Walker I, et al. Cognitive behaviour therapy for health anxiety: A systematic review and meta-analysis. Behav Cogn Psychother. 2017;45(2):110–123.
   PubMed Web of Science ®Google Scholar
• Liu J, Gill NS, Teodorczuk A, et al. The efficacy of cognitive behavioural therapy in somatoform disorders and medically unexplained physical symptoms: A meta-analysis of randomized controlled trials. J Affect Disord. 2019;245:98–112.
   PubMed Web of Science ®Google Scholar
• Lilienfeld SO, McKay D, Hollon SD. Why randomised controlled trials of psychological treatments are still essential. Lancet Psychiatry. 2018;5(7):536–538.
   PubMed Web of Science ®Google Scholar
• Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.
   PubMed Web of Science ®Google Scholar
• Konnopka A, Schaefert R, Heinrich S, et al. Economics of medically unexplained symptoms: a systematic review of the literature. Psychother Psychosom. 2012;81(5):265–275.
   PubMed Web of Science ®Google Scholar
• Bramer WM, Giustini D, de Jonge GB, et al. De-duplication of database search results for systematic reviews in EndNote. J Med Libr Assoc. 2016;104(3):240–243.
   PubMed Web of Science ®Google Scholar
• Dimsdale JE, Creed F, Escobar J, et al. Somatic symptom disorder: an important change in DSM. J Psychosom Res. 2013;75(3):223–228.
   PubMed Web of Science ®Google Scholar
• Fink P. Syndromes of bodily distress or functional somatic syndromes - where are we heading. Lecture on the occasion of receiving the Alison Creed award 2017. J Psychosom Res. 2017;97:127–130.
   PubMed Web of Science ®Google Scholar
• Lipsey MW, Wilson DB. Practical meta-analysis. Thousand Oaks, CA: Sage Publications, Inc; 2001.
   Google Scholar
• Warwick HM, Clark DM, Cobb AM, et al. A controlled trial of cognitive-behavioural treatment of hypochondriasis. Br J Psychiatry. 1996;169(2):189–195.
   PubMed Web of Science ®Google Scholar
• Clark DM, Salkovskis PM, Hackmann A, et al. Two psychological treatments for hypochondriasis: A randomised controlled trial. Br J Psychiatry. 1998;173:218–225.
   PubMed Web of Science ®Google Scholar
• Weck F, Neng JM, Richtberg S, et al. Cognitive therapy versus exposure therapy for hypochondriasis (health anxiety): A randomized controlled trial. J Consult Clin Psychol. 2015;83(4):665–676.
   PubMed Web of Science ®Google Scholar
• Skjernov M. Group cognitive behaviour therapy for severe health anxiety: A randomised controlled trial. Copenhagen, Denmark: University of Copenhagen; 2017.
   Google Scholar
• Fallon BA, Ahern DK, Pavlicova M, et al. A randomized controlled trial of medication and cognitive-behavioral therapy for hypochondriasis. Am J Psychiatry. 2017;174(8):756–764.
   PubMed Web of Science ®Google Scholar
• Jacobson NS, Truax P. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol. 1991;59(1):12–19.
   PubMed Web of Science ®Google Scholar
• Higgins JP, Altman DG, Gotzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.
   PubMed Web of Science ®Google Scholar
• R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2016.
   Google Scholar
• Viechtbauer W. Conducting meta-analyses in R with the metafor package. J Stat Softw. 2010;36(3):1–48.
   Web of Science ®Google Scholar
• Hedges LV. Distribution theory for Glass’s estimator of effect size and related estimators. J Educ Behav Stat. 1981;6(2):107–128.
   Google Scholar
• Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
   Google Scholar
• Buwalda FM, Bouman TK, van Duijn MA. Psychoeducation for hypochondriasis: a comparison of a cognitive-behavioural approach and a problem-solving approach. Behav Res Ther. 2007;45(5):887–899.
   PubMed Web of Science ®Google Scholar
• Salkovskis PM, Rimes K, Warwick H, et al. The health anxiety inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychol Med. 2002;32(5):843–853.
   PubMed Web of Science ®Google Scholar
• Kellner R. Somatization and hypochondriasis. New York: Praeger Publishers; 1986.
   Google Scholar
• Muraki E, Hombo CM, Lee YW. Equating and linking of performance assessments. Appl Psychol Meas. 2000;24(4):325–337.
   Web of Science ®Google Scholar
• Hedman E, Axelsson E, Andersson E, et al. Exposure-based cognitive-behavioural therapy via the internet and as bibliotherapy for somatic symptom disorder and illness anxiety disorder: randomised controlled trial. Br J Psychiatry. 2016;209(5):407–413.
   PubMed Web of Science ®Google Scholar
• Lovas DA, Barsky AJ. Mindfulness-based cognitive therapy for hypochondriasis, or severe health anxiety: a pilot study. J Anxiety Disord. 2010;24(8):931–935.
   PubMed Web of Science ®Google Scholar
• Wahl I, Löwe B, Bjorner JB, et al. Standardization of depression measurement: a common metric was developed for 11 self-report depression measures. J Clin Epidemiol. 2014;67(1):73–86.
   PubMed Web of Science ®Google Scholar
• Svanborg P, Åsberg M. A new self-rating scale for depression and anxiety states based on the comprehensive psychopathological rating scale. Acta Psychiatr Scand. 1994;89(1):21–28.
   PubMed Web of Science ®Google Scholar
• Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: A preliminary report. J Psychiatr Res. 1982;17(1):37–49.
   PubMed Web of Science ®Google Scholar
• Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–560.
   PubMed Web of Science ®Google Scholar
• Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–634.
   PubMed Web of Science ®Google Scholar
• Duval S, Tweedie R. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455–463.
   PubMed Web of Science ®Google Scholar
• Axelsson E, Andersson E, Ljótsson B, et al. Cost-effectiveness and long-term follow-up of three forms of minimal-contact cognitive behaviour therapy for severe health anxiety: results from a randomised controlled trial. Behav Res Ther. 2018;107:95–105.
   PubMed Web of Science ®Google Scholar
• Bovell CV. Randomized controlled feasibility trial of a self-help book for health anxiety. Regina, Canada: University of Regina; 2012.
   Google Scholar
• Visser S, Bouman TK. The treatment of hypochondriasis: exposure plus response prevention vs cognitive therapy. Behav Res Ther. 2001;39(4):423–442.
   PubMed Web of Science ®Google Scholar
• Bourgault-Fagnou MD, Hadjistavropoulos HD. A randomized trial of two forms of cognitive behaviour therapy for an older adult population with subclinical health anxiety. Cogn Behav Ther. 2013;42(1):31–44.
   PubMed Web of Science ®Google Scholar
• Tyrer P, Cooper S, Salkovskis P, et al. Clinical and cost-effectiveness of cognitive behaviour therapy for health anxiety in medical patients: a multicentre randomised controlled trial. Lancet. 2014;383(9913):219–225.
   PubMed Web of Science ®Google Scholar
• Morriss R, Patel S, Malins S, et al. Clinical and economic outcomes of remotely delivered cognitive behaviour therapy versus treatment as usual for repeat unscheduled care users with severe health anxiety: a multicentre randomised controlled trial. BMC Med. 2019;17(1):16.
   PubMedGoogle Scholar
• Weck F, Neng JM. Response and remission after cognitive and exposure therapy for hypochondriasis. J Nerv Ment Dis. 2015;203(11):883–885.
   PubMed Web of Science ®Google Scholar
• Hedman E, Andersson G, Andersson E, et al. Internet-based cognitive-behavioural therapy for severe health anxiety: randomised controlled trial. Br J Psychiatry. 2011;198(3):230–236.
   PubMed Web of Science ®Google Scholar
• Greeven A, van Balkom AJ, Visser S, et al. Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a randomized controlled trial. Am J Psychiatry. 2007;164(1):91–99.
   PubMed Web of Science ®Google Scholar
• Sørensen P, Birket-Smith M, Wattar U, et al. A randomized clinical trial of cognitive behavioural therapy versus short-term psychodynamic psychotherapy versus no intervention for patients with hypochondriasis. Psychol Med. 2011;41(2):431–441.
   PubMed Web of Science ®Google Scholar
• Hedman E, Axelsson E, Görling A, et al. Internet-delivered exposure-based cognitive-behavioural therapy and behavioural stress management for severe health anxiety: randomised controlled trial. Br J Psychiatry. 2014;205(4):307–314.
   PubMed Web of Science ®Google Scholar
• Newby JM, Smith J, Uppal S, et al. Internet-based cognitive behavioral therapy versus psychoeducation control for illness anxiety disorder and somatic symptom disorder: A randomized controlled trial. J Consult Clin Psychol. 2018;86(1):89–98.
   PubMed Web of Science ®Google Scholar
• Hedman E, Andersson E, Lindefors N, et al. Cost-effectiveness and long-term effectiveness of internet-based cognitive behaviour therapy for severe health anxiety. Psychol Med. 2013;43(2):363–374.
   PubMed Web of Science ®Google Scholar
• Barsky AJ, Ahern DK. Cognitive behavior therapy for hypochondriasis: a randomized controlled trial. JAMA. 2004;291(12):1464–1470.
   PubMed Web of Science ®Google Scholar
• Seivewright H, Green J, Salkovskis P, et al. Cognitive-behavioural therapy for health anxiety in a genitourinary medicine clinic: randomised controlled trial. Br J Psychiatry. 2008;193(4):332–337.
   PubMed Web of Science ®Google Scholar
• Hedman E, Andersson E, Ljótsson B, et al. Cost effectiveness of internet-based cognitive behaviour therapy and behavioural stress management for severe health anxiety. BMJ Open. 2016;6(4):e009327.
   PubMed Web of Science ®Google Scholar
• Axelsson E, Lindsäter E, Ljótsson B, et al. The 12-item self-report World Health Organization Disability Assessment Schedule (WHODAS) 2.0 administered via the internet to individuals with anxiety and stress disorders: a psychometric investigation based on data from two clinical trials. JMIR Ment Health. 2017;4(4):e58.
   PubMedGoogle Scholar
• Mataix-Cols D, Fernandez de la Cruz L, Nordsletten AE, et al. Towards an international expert consensus for defining treatment response, remission, recovery and relapse in obsessive-compulsive disorder. World Psychiatry. 2016;15(1):80–88.
   PubMed Web of Science ®Google Scholar