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Cognitive-behavioral treatment W Somatoform disorders Background: Predictors of treatment outcome were eval-uated in a clinical sample suffering from hypochondria-sis. Methods: The sample consisted of 96 patients with hypochondriacal disorder according to DSM-IV or high syndrome scores on the Illness Attitude Scales (IAS) or Whiteley Index (WI). After intense inpatient cognitive-behavioral treatment (CBT), 60 % of the patients were classified as responders because of substantial improve-ments or recovery from hypochondriacal symptomatolo-gy. Results: Non-responders were characterized by a higher degree of pre-treatment hypochondriasis, more somatization symptoms and general psychopathology (SCL-90R), more dysfunctional cognitions related to bodily functioning, higher levels of psychosocial impair-ments, and more utilization of the health care system as indicated by the number of hospital days and costs for inpatient treatments and medication. No predictive value was found for sociodemographic variables, comorbidity with other mental disorders and chronicity. Multiple linear regression showed that pre-treatment variables significantly predicted IAS scores at post-treatment (R2 = 0.59), changes during treatment (0.10), IAS scores at fol-low-up two years later (0.41) and changes between base-line and follow-up (0.25). Conclusions: The results dem-onstrate the relevance of various psychopathological variables and health care utilization as important indica-tors for outcome and further course of clinical hypochon-driasis