A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis).
Open accessAbstract
OBJECTIVE: The efficacy and acceptability of existing psychological interventions for health anxiety (hypochondriasis) are limited. In the current study, the authors 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) with unrestricted services (US) alone. METHOD: The 74 participants were randomized to either MBCT in addition to US (n = 36) or US alone (n = 38). Participants were assessed prior to intervention (MBCT or US), immediately following the intervention, and 1 year postintervention. 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: In the intention-to-treat (ITT) analysis (N = 74), MBCT participants had significantly lower health anxiety than US participants, both immediately following the intervention (Cohen's d = 0.48) and at 1-year follow-up (d = 0.48). The per-protocol (PP) analysis (n = 68) between groups effect size was d = 0.49 at postintervention and d = 0.62 at 1-year follow-up. Mediational analysis showed that change in mindfulness mediated the group changes in health anxiety symptoms. Significantly fewer participants allocated to MBCT than to US met criteria for the diagnosis of hypochondriasis, both immediately following the intervention period (ITT 50.0% vs. 78.9%; PP 47.1% vs. 78.4%) and at 1-year follow-up (ITT 36.1% vs. 76.3%; PP 28.1% vs. 75.0%). CONCLUSIONS: MBCT may be a useful addition to usual services for patients with health anxiety.
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Systematic reviews and meta-analyses have established the effectiveness of different psychological interventions for health anxiety.
“Systematic reviews and meta-analyses have established the effectiveness of different psychological interventions [6, 11–17]”
From Cost Effectiveness of Internet-Delivered Acceptance and Commitment Therapy for Patients with Severe Health Anxiety: A Randomised Controlled Trial (2022) · cites this paper as [15]
The paper’s Abstract reports that a Cochrane review found the strongest evidence for CBT in hypochondriasis, with several studies reporting positive outcomes. Its Results > Health Anxiety Measures also report a benefit of mindfulness-based cognitive therapy in this trial. It does not say that systematic reviews and meta-analyses established the effectiveness of different interventions for health anxiety, and it emphasizes limitations in the existing evidence. No page numbers are available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe study by McManus et al (2012) was the first to use a group format for treating health anxiety in a randomised controlled trial.
“The study by McManus et al (2012) was the fi rst to use a group format for treating health anxiety in a randomised controlled trial (RCT).”
From Health anxiety: Detection and treatment (2018) · cites this paper as McManus et al 2012
The Method (Interventions; page not provided) describes MBCT delivered in group classes, and the Method (Study Objectives and Design; page not provided) identifies this as a randomized trial for health anxiety. The Discussion calls it the first randomized controlled trial of MBCT for health anxiety, but does not establish the broader claim that it was the first trial to use any group-format treatment for health anxiety. (LLM, conf=0.87)
Experimental — accuracy not yet measuredMindfulness interventions have been shown to successfully decrease health anxiety.
“Although mindfulness interventions have been shown to successfully decrease health anxiety (Eilenberg, Kronstrand, Fink, & Frostholm, 2013; Lovas & Barsky, 2010; McManus, Surawy, Muse, Vazquez-Montes, & Williams, 2012)”
From An examination of mindfulness skills in terms of affect tolerance among individuals with elevated levels of health anxiety. (2018) · cites this paper as McManus et al., 2012
For health anxiety, the only two third wave RCTs on adults found a medium effect of MBCT tailored to health anxiety and a high effect of ACT.
“For HA, the only two third wave RCTs on adults found a medium effect of MBCT tailored to HA (McManus et al., 2012) and high effect of ACT (Eilenberg et al., 2016).”
From Third wave treatments for functional somatic syndromes and health anxiety across the age span: A narrative review (2019) · cites this paper as McManus et al., 2012
Mindfulness-based group cognitive therapy compared with usual unrestricted services in 74 patients produced a medium effect size of 0.48 (intention-to-treat) to 0.62 (per-protocol) at 1-year follow-up and a low drop-out rate of 6%.
“reported a medium effect size of 0.48 (intention-to-treat analysis) to 0.62 (perprotocol analysis) at 1-year follow-up and a low drop-out rate of 6%.”
From Health anxiety: Detection and treatment (2018) · cites this paper as McManus et al 2012
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- Authors
- McManus, F., Surawy, C., Muse, K., Vazquez-Montes, M., & Williams, J. M. G.
- Affiliations
- Warneford Hospital (GB)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2012-10
- Volume
- 80
- Issue
- 5
- Pages
- 817-828
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC3450431
- OpenAlex
- W2167369045
- Cited by
- 179
- References
- 54
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 5 · 2023: 10 · 2022: 9 · 2021: 10 · 2020: 11 · 2019: 11 · 2018: 12 · 2017: 17 · 2016: 22 · 2015: 19 · 2014: 33 · 2013: 7
- FWCI
- 21.36
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Repository (University of Gloucestershire) (acceptedVersion)
- Research Repository (University of Gloucestershire) (submittedVersion)
- Worcester Research and Publications (University of Worcester) (submittedVersion)
- Funders
- Wellcome Trust (G067797)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- mindfulness-based cognitive therapy, health anxiety, usual care, psychological intervention, mindfulness, treatment efficacy, acceptability, long-term follow-up
- MeSH terms
- Adult, Anxiety, Female, Follow-Up Studies, Humans, Hypochondriasis, Male, Middle Aged, Severity of Illness Index, Cognitive Behavioral Therapy, Treatment Outcome, Meditation
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