Mindfulness-Based Cognitive Therapy for Health Anxiety: A randomised trial

Anxiety about health will affect most people at some point in their lives. It is a common reaction to new or unexplained bodily symptoms, to physical illness or medical tests, or to media coverage of a specific disease. It is usually transient, subsiding spontaneously as symptoms are resolved or dealt with by appropriate medical reassurance. In contrast, severe health anxiety (hypochondriasis) persists, is rarely allayed for long by medical reassurance, and tends to shift from one symptom to another, becoming a clinically significant problem for sufferers, their families and the health professionals involved in their care. The study described below investigated how effective Mindfulness-Based Cognitive Therapy (MBCT) was in helping people with anxiety about their health. The study was funded by a Canadian charity, the Lupina Foundation, who fund research which is aimed at reducing the adverse effects of health anxiety and increasing access to healthcare services. Principal Investigators were: Dr Freda McManus and Professor Mark Williams.

Objective of the study: The efficacy and acceptability of existing psychological interventions for health anxiety (hypochondriasis) is limited.  The current study 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) to unrestricted services (US) alone.

BellsMethod: Seventy-four people who met criteria for the diagnosis of hypochondriasis too part in the study and were randomized to either (i) MBCT in addition to US (n = 36) or (ii) US alone (n = 38).  Participants were assessed prior to intervention (MBCT or US), immediately following the intervention, and at one year post-intervention. 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.

Results: The participants who were allocated to MBCT had significantly lower health anxiety than US participants, both immediately following the intervention and at one year follow-up (medium effect sizes). Similarly, significantly fewer participants allocated to MBCT than to US met criteria for the diagnosis of hypochondriasis, both immediately following the intervention period  and at one year follow-up. Furthermore, mediational analysis showed that changes in mindfulness mediated the group changes in health anxiety symptoms.

Conclusions: The MBCT intervention seemed to be acceptable to participants in this study, and may be a useful addition to usual services for patients with health anxiety.

The authors would like to express their gratitude both to the Lupina Foundation for funding the study, and to the participants who generously gave their time to take part.

Principal Investigators: Dr Freda McManus, Professor Mark Williams.

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