September 7, 2017

expert reaction to CBT for health anxiety

A new study, published in Health Technology Assessment,  investigate the use of cognitive behavioural therapy (CBT) for health anxiety.

A briefing accompanied this roundup.

Prof. Naomi Fineberg, Consultant Pyschiatrist at Hertfordshire Partnership University NHS Foundation Trust (HPFT) and Visiting Professor in Psychiatry, University of Hertfordshire, said:

“Health anxiety is common and carries a significant cost and burden for patients and health services. Tyrer and colleagues’ timely research found some benefit for a form of psychological therapy. However the study had limitations inasmuch as a large proportion of eligible patients were not tested so the results may not be representative. Of note, the study treatment did not turn out to be cost effective on a standard quality of life measure. The study draws attention to the unmet need for clinical and cost-effective treatments that would be acceptable to patients seeking physical treatments because of health anxiety.”

Prof. John Chambers, Professor of Clinical Cardiology and Consultant Cardiologist, Guy’s and St Thomas Hospitals, said:

“The study is important in showing that health anxiety is common in medical clinics and amenable to psychological therapies.  We know that health anxiety in patients causes repeated attendance in A and E, GP surgeries and medical outpatient clinics.  It leads to over-investigation by clinicians who do not consider a psychological component to the symptom complex and repeatedly invoke medical protocols.  This process tends to entrench the idea that the patient has some dangerous problem not amenable to conventional diagnosis.  We need to add a consideration of psychological processes to our established protocols in order to trigger access to psychological interventions.  These then need to take place locally and not at a site distant from the patient’s presentation so as to avoid the implied but unhelpful and artificial mind/body separation.”

* ‘Cognitive–behaviour therapy for health anxiety in medical patients (CHAMP): a randomised controlled trial with outcomes to 5 years’ by Tyrer et al. published in Health Technology Assessment on Thursday 7^th September.

Declared interests

Prof. Fineberg: I have received funding for research from Lundbeck, ECNP, SErvier, UK MRC, UK NIHR. I have acted as a consultant to Transcept and Servier. I have additionally received funding for research from Shire and for giving lectures from Abbott, Otsuka and Lundbeck.”

Prof. Chambers: None received