Cognitive-behavioural therapy for health anxiety in a genitourinary medicine clinic: randomised controlled trial.

BACKGROUND: Little is known about the management of health anxiety and hypochondriasis in secondary care settings. AIMS: To determine whether cognitive-behavioural therapy (CBT) along with a supplementary manual was effective in reducing symptoms and health consultations in patients with high health anxiety in a genitourinary medicine clinic. METHOD: Patients with high health anxiety were randomly assigned to brief CBT and compared with a control group. RESULTS: Greater improvement was seen in Health Anxiety Inventory (HAI) scores (primary outcome) in patients treated with CBT (n=23) than in the control group (n=26) (P=0.001). Similar but less marked differences were found for secondary outcomes of generalised anxiety, depression and social function, and there were fewer health service consultations. The CBT intervention resulted in improvements in outcomes alongside higher costs, with an incremental cost of pound 33 per unit reduction in HAI score. CONCLUSIONS: Cognitive-behavioural therapy for health anxiety within a genitourinary medicine clinic is effective and suggests wider use of this intervention in medical settings.