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Objective: This study, to the authors' knowledge, is the first randomized controlled trial comparing the efficacy of cognitive behavior therapy (CBT), paroxetine, and a placebo (administered in a double blind fashion) in the treatment of hypochondriasis. Method: The authors randomly assigned 112 subjects with hypochondriasis according to DSM-IV criteria to 16 weeks of outpatient treatment with CBT, paroxetine, or a placebo. The main outcome measure was the Whiteley Index. The authors made pretest and posttest assessments and analyzed all outcome measures using a General Linear Model 3x2 repeated measures analysis of variance with Helmert contrasts. The authors considered subjects who scored at least one standard deviation below the mean pretest score on the Whiteley Index as responders. All analyses were conducted on intent-to-treat and completer bases. Results: On the Whiteley Index, Helmert contrasts on the intent-to-treat and completer cohorts revealed that pooled CBT and paroxetine were significantly superior to placebo, but did not differ significantly from each other. The responder analysis on the intent-to-treat cohort and completer cohort, respectively, revealed the following percentages of responders per group: CBT group, 45% and 54%; paroxetine group, 30% and 38%; and placebo group, 14% and 12%. In the intent-to-treat analysis, only CBT differed significantly from the placebo. In the completer analysis, both paroxetine and CBT differed significantly from the placebo. Conclusions: CBT or paroxetine are effective short-term treatment options for subjects with hypochondriasis.

The treatment of hypochondriasis continues to be challenging because of the nature of hypochondriasis and reactions that it often elicits in therapists. In this paper, it is argued that due to complex interactions between hypochondriacal patients and their therapists, there should be a radically different approach to treating hypochondriacal patients. Within such a framework, it is crucial to determine whether therapists are 'eligible' to treat hypochondriacal patients, rather than whether hypochondriacal patients fulfill criteria for particular types of treatment. Regardless of the specific treatment modality used, it is suggested that treatment of hypochondriasis should always entail empathy, acceptance, understanding, and explanation and education. In addition, good therapeutic results can be achieved and therapeutic pessimism about hypochondriasis overcome if therapists are accessible, reliable, and flexible, if their behavior is consistent and predictable, and if they express themselves clearly and in unequivocal terms.

Introduction Many patients are seen in clinical practice with physical symptoms for which no medical explanation can be found. In one study among 191 new referrals to a general medical [...]

Objective: This study examined the longitudinal course of patients known to have had a previous episode of transient hypochondriasis. Method: Twenty-two transiently hypochondriacal patients and 24 nonhypochondriacal patients from the same general medical clinic were reexamined after an average of 22 months with the use of self-report questionnaires, structured diagnostic interviews, and medical record review. Results: The hypochondriacal patients continued to manifest significantly more hypochondriacal symptoms, more somatization, and more psychopathological symptoms at follow-up. They also reported significantly more amplification of bodily sensations and more functional disability and utilized more medical care. These differences persisted after control for differences in medical morbidity and marital status. Only one hypochondriacal patient, however, had a DSM-III-R diagnosis of hypochondriasis at follow-up. Multivariate analyses revealed that the only significant predictors of hypochondriacal symptoms at follow-up were hypochondriacal symptoms and the tendency to amplify bodily sensations at the baseline evaluation. Conclusions: Hypochondriacal symptoms appear to have some temporal stability: patients who experienced hypochondriacal episodes at the beginning of the study were significantly more hypochondriacal 2 years later than comparison patients. They were not, however, any more likely to develop DSM-III-R-defined hypochondriasis. Thus, hypochondriacal symptoms may be distinct from the axis I disorder. The data are also compatible with the hypothesis that preexisting amplification of bodily sensations is an important predictor of subsequent hypochondriacal symptoms.

Most patients somatize at some point in their lives but in a self-limited way that resolves without treatment or with medical reassurance. Far fewer, perhaps 1%, have strictly defined somatization [...]

Tuning in to your intuition is one of the hardest lessons you can learn. And when your health is involved, you may feel as if you're overreacting or letting fear […]

Synopsis: This brief, individual CBT intervention, developed specifically to alter hypochondriacal thinking and restructure hypochondriacal beliefs, appears to have significant beneficial long-term effects on the symptoms of hypochondriasis. Source: Barsky [...]

The years had not been kind to Joe. He came from a broken home, which is to say a cocaine-fuelled madman had crashed a JCB into his house, and his [...]

Not much is know about effective interventions for people with hypochondriasis. Single case experimental research (SCER) concentrates on the experience of individuals and its translation into a measurable form. It can help nurses to know more about their clients, but it does not yet have broad acceptance. A case study is described including initial clinical sessions which were used as a baseline measurement and to develop a collaborative working relationship.

Introduction Cognitive educational treatment for hypochondriasis, was first proposed by Barsky and colleagues [1 2] but patients with hypochondriasis are usually reluctant to accept referral to a psychiatrist because they [...]

Dr Stuart Handysides takes up recreational medicine - seeing patients who are not ill. My mum was a nurse in the early 1970s. She liked to keep up to date, [...]

Byline: Altshul, Sara Imagine the lost punch lines: If Woody Allen would have signed up for 6 weeks of cognitive-behavioral therapy (CBT) instead of decades of Freudian psychoanalysis, his career [...]

Steve Ford HYPOCHONDRIA CAN be effectively treated with cognitive behavioural therapy, accord- ing to US psychiatrists. Compared with usual care, weekly CBT sessions over six weeks led to improved social [...]

MINNEAPOLIS -- Somatizers often are frustrating patients, but they also can be the most rewarding patients to treat. First you must step outside the biomedical model that you learned in [...]

From time to time, I think about my health. Sometimes I do this like a casual, detached observer performing a semiannual audit. Sometimes I approach it with the frenzy of [...]

Many people see their doctor unnecessarily or for trivial matters. Furthermore, many are not satisfied with what they are told and insist on this or that form of investigation, referral, [...]

You've probably heard the term hypochondriac, and maybe you've even used it to describe that friend of yours who won't share her soda because she's afraid of germs. But being […]

Hypochondriacs can significantly lower their health-related anxiety with the help of a few therapy sessions, according to a recent study. Researchers worked with 187 patients with hypochondria. They randomly assigned [...]

PHOENIX, ARIZ. -- A meta-analysis incorporating 12 treatment studies indicates that antidepressants and cognitive-behavioral therapy both work well in the treatment of hypochondriasis. Treatment with other forms of psychotherapy showed [...]