Cognitive and behavioural treatment of hypochondriasis

Background: This study investigates the feasibility and effectiveness of time-limited treatment protocols based upon cognitive and behavioural interventions. Method: Seventeen patients with DSM-IV diagnoses of hypochondriasis were offered 12 1-hour sessions of either 'pure' cognitive or 'pure' behavioural (i.e. exposure in vivo and response prevention) treatment. Patients were used as their own controls by observing a 4-week period without interventions before and after treatment. Results: Patients in both treatment conditions improved on specific measures of hypochondriasis (Kellner's Illness Attitude Scales) and depression. These changes took place during the active treatment period, whereas in the control periods scores remained unchanged. Furthermore, no differential treatment effectiveness could be demonstrated. Conclusions: Cognitive and behavioural interventions seem to be active ingredients in the treatment of hypochondriasis, although the contribution of nonspecific factors (e.g. patient motivation, therapist attitudes, and the therapeutic relationship) requires further study.