Cognitive–behavioural therapy for health anxiety in a genitourinary medicine clinic: randomised controlled trial
Open accessAbstract
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 £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.
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Using the Health Anxiety Inventory as the outcome measure, CBT was found to be cost effective regardless of the form of delivery.
“Using the Health Anxiety Inventory (HAI) as the outcome measure, CBT was found to be cost effective regardless of the form of delivery.”
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 [30]
The Method and Economic evaluation sections use the HAI as the outcome measure and report an incremental cost of £33 per unit reduction in HAI score. They do not establish cost-effectiveness regardless of delivery form: the trial evaluated clinic-based CBT, and its cost-effectiveness varied substantially when intervention costs were changed. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThese results are similar to previous iCBT studies that reported the same tendency but found no statistically significant differences in costs between groups at follow-up.
“These results are similar to those from the previous iCBT studies [16, 26, 27, 30] that reported the same tendency but found no statistically significant differences in costs between groups at follow-up”
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 [30]
The Economic evaluation reports lower service costs in the CBT group, but higher total costs once treatment was included; neither difference was statistically significant. The treatment description says patients attended CBT sessions at the clinic, so this source does not support calling it an iCBT study. (LLM, conf=0.90)
Experimental — accuracy not yet measuredOnly a few studies have examined the costs and cost effectiveness of iCBT programmes for health anxiety, and their control groups, follow-up periods, outcome measures, and methods for economic evaluation differed from those in this study.
“Only a few studies have examined the costs and cost effectiveness of iCBT programmes for health anxiety [16, 27, 30], and their control groups, follow-up periods, outcome measures, and methods for economic evaluation differed from those in our study.”
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 [30]
The Method and Economic evaluation sections describe a cost-effectiveness analysis for CBT for health anxiety, with a control group, 12-month follow-up, and specified outcomes. But the treatment was delivered in therapist-led clinic sessions with a booklet, not as an internet-based CBT (iCBT) programme. This source also cannot establish how its methods differed from those of the citing authors’ study. (LLM, conf=0.88)
Experimental — accuracy not yet measuredCognitive behavior therapy is an effective treatment for severe health anxiety and has substantial empirical support.
“Cognitive behavior therapy (CBT) has been shown to be an effective treatment for severe health anxiety and has substantial empirical support [6,7,8,9,10].”
From Mediators in Internet-Based Cognitive Behavior Therapy for Severe Health Anxiety (2013) · cites this paper as [6]
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- Authors
- Seivewright, H., Green, J., Salkovskis, P., Barrett, B., Nur, U., & Tyrer, P.
- Affiliations
- Kings Mill Hospital (GB)
- King's College London (GB)
- London School of Hygiene & Tropical Medicine (GB)
- Imperial College London (GB)
- Corresponding author
- Seivewright, Helen
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2008-10
- Volume
- 193
- Issue
- 4
- Pages
- 332-337
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2096373733
- Cited by
- 81
- References
- 31
- Citations by year
- 2026: 2 · 2025: 3 · 2023: 4 · 2022: 5 · 2021: 2 · 2020: 5 · 2019: 5 · 2018: 3 · 2017: 10 · 2016: 6 · 2015: 2 · 2014: 6 · 2013: 7 · 2012: 7
- FWCI
- 6.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (07/01/26)
- Sir Jules Thorn Charitable Trust
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- cognitive behavioral therapy, health anxiety, genitourinary medicine, secondary care, Health Anxiety Inventory, generalized anxiety disorder, depression, social function, cost-effectiveness
- MeSH terms
- Adolescent, Adult, Aged, Anxiety Disorders, Female, Humans, Male, Middle Aged, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult
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