The DOI matches its Crossref record; 40 of the 43 references it cites were found in a registry or an index.
Exposure-based cognitive–behavioural therapy via the internet and as bibliotherapy for somatic symptom disorder and illness anxiety disorder: randomised controlled trial
Open accessAbstract
Background: In DSM-5 two new diagnoses, somatic symptom disorder (SSD) and illness anxiety disorder (IAD), have replaced DSM-IV hypochondriasis. There are no previous treatment studies for these disorders. Cognitive–behavioural therapy (CBT) delivered as therapist-guided or unguided internet treatment or as unguided bibliotherapy could be used to increase treatment accessibility. Aims: To investigate the effect of CBT delivered as guided internet treatment (ICBT), unguided internet treatment (U-ICBT) and as unguided bibliotherapy. Method: A randomised controlled trial (RCT) where participants (n= 132) with a diagnosis of SSD or IAD were randomised to ICBT, U-ICBT, bibliotherapy or to a control condition on a waiting list (trial registration: Clinicaltrials.gov identifier NCT01966705). Results: Compared with the control condition, all three treatment groups made large and significant improvements on the primary outcome Health Anxiety Inventory (between-group d at post-treatment was 0.80–1.27). Conclusions: ICBT, U-ICBT and bibliotherapy can be highly effective in the treatment of SSD and IAD. This is the first study showing that these new DSM-5 disorders can be effectively treated.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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 [13]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In a series of randomised controlled trials (RCTs), Hedman and colleagues have demonstrated the efficacy of internet-delivered CBT (iCBT) for health anxiety, and showed that it outperforms control groups (online forums and internet-delivered behavioural stress management), and leads to improvements in health anxiety that are maintained up to 1-year follow-up ( Hedman et al., 2011 ; Hedman, AxelSSO”
From Internet-Based Cognitive Behavioral Therapy Versus Psychoeducation Control for Illness Anxiety Disorder and Somatic Symptom Disorder: A Randomized Controlled Trial (2018) · cites this paper as Hedman et al., 2016
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Finally, previous studies have evaluated iCBT delivered either with intensive, weekly therapist guidance or without any support ( Hedman et al., 2016 )”
From Internet-Based Cognitive Behavioral Therapy Versus Psychoeducation Control for Illness Anxiety Disorder and Somatic Symptom Disorder: A Randomized Controlled Trial (2018) · cites this paper as Hedman et al., 2016
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Evidence also supports the delivery of CBT for health anxiety and IAD online [26, 58, 77], with large effect sizes when delivered in routine care [78, 79].”
From Illness Anxiety Disorder: A Review of the Current Research and Future Directions (2024) · cites this paper as [77]
The cited source says what the claim attributes to it.
In the citing paper
“This is the first RCT to independently replicate the findings of Hedman and colleagues' studies, and demonstrate that the efficacy of iCBT for health anxiety generalises to an Australian sample with DSM-5 IAD and SSD (replicating Hedman et al., 2016).”
From Internet-Based Cognitive Behavioral Therapy Versus Psychoeducation Control for Illness Anxiety Disorder and Somatic Symptom Disorder: A Randomized Controlled Trial (2018) · cites this paper as Hedman et al., 2016
The cited source says what the claim attributes to it.
In the citing paper
“Second, with the exception of one study which showed iCBT was efficacious in patients who met criteria for DSM-5 IAD or SSD (Hedman et al. 2016), all past research has evaluated CBT (and iCBT) in patients with DSM-IV Hypochondriasis.”
From Internet-Based Cognitive Behavioral Therapy Versus Psychoeducation Control for Illness Anxiety Disorder and Somatic Symptom Disorder: A Randomized Controlled Trial (2018) · cites this paper as Hedman et al. 2016
The cited source says what the claim attributes to it.
In the citing paper
“In 3 randomized controlled trials (RCTs), Hedman-Lagerlöf and colleagues showed that iCBT can be highly effective for severe health anxiety [15-17].”
From Development and Feasibility Testing of Internet-Delivered Acceptance and Commitment Therapy for Severe Health Anxiety: Pilot Study. (2018) · cites this paper as [17]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
(1998) · The Journal of Clinical Psychiatry · Cited by 19,139
An inventory for measuring clinical anxiety: Psychometric properties.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.56.6.893 · Cited by 14,407
Jacobson, N. S., & Truax, P. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.1.12 · Cited by 7,770
Linear Mixed Models for Longitudinal Data
Verbeke, G. (1997) · Lecture Notes in Statistics · doi:10.1007/978-1-4612-2294-1_3 · Cited by 3,506
Anxiety, sensitivity, anxiety frequency, and the prediction of fearfulness
Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986) · Behaviour Research and Therapy · doi:10.1016/0005-7967(86)90143-9 · Cited by 3,169
The client satisfaction questionnaire
Attkisson, C. C., & Zwick, R. (1982) · Evaluation and Program Planning · doi:10.1016/0149-7189(82)90074-x · Cited by 1,743
Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: A meta-analysis
SPEK, V., CUIJPERS, P., NYKLÍČEK, I., RIPER, H., KEYZER, J., & POP, V. (2007) · Psychological Medicine · doi:10.1017/s0033291706008944 · Cited by 1,586
Credibility of analogue therapy rationales
Borkovec, T. D., & Nau, S. D. (1972) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/0005-7916(72)90045-6 · Cited by 1,553
Gueorguieva, R., & Krystal, J. H. (2004) · Archives of General Psychiatry · doi:10.1001/archpsyc.61.3.310 · Cited by 1,529
Flagged first, then by citations
3 of the 43 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- 1994, Diagnostic and Statistical Manual of Mental Disorder (4th edn) (DSM-IV)
Cited by
Sorted by citations
Items 101–119 of 119
Günaydın, N., & Demirel, S. (2024) · Ege Üniversitesi Hemşirelik Fakültesi Dergisi · doi:10.53490/egehemsire.1208756
Somatic Symptoms and Related Disorders: A General Overview
Zhang, T. (2024) · SHS Web of Conferences · doi:10.1051/shsconf/202419303005
Murphy, M. J., Storer, B., Kershaw, K. A., Begg, H. E., Burdekin, P., Harvey, S. B., Millard, M., Sharma, S. K., Salehi, C., & Newby, J. M. (2024) · Research Square · doi:10.21203/rs.3.rs-4458107/v1
van Eickels, D., & Haun, M. W. (2024) · PiD - Psychotherapie im Dialog · doi:10.1055/a-2249-8096
General principles of management of somatization
Orsolini, L., Cicolini, A., Salvi, V., & Volpe, U. (2025) · doi:10.1093/med/9780192858290.003.0019
Çakır, O., & Çetinkaya, A. (2025) · Balıkesır Health Sciences Journal · doi:10.53424/balikesirsbd.1615505
Axelsson, E., Österman, S., & Hedman-Lagerlöf, E. (2023) · Figshare · doi:10.6084/m9.figshare.24098310
Self-citationAxelsson, E., Österman, S., & Hedman-Lagerlöf, E. (2023) · Figshare · doi:10.6084/m9.figshare.24098313
Self-citationHybelius, J., Gustavsson, A., af Winklerfelt Hammarberg, S., Toth-Pal, E., Johansson, R., Ljótsson, B., & Axelsson, E. (2022) · Figshare · doi:10.6084/m9.figshare.20342406
Self-citationAxelsson, E., Österman, S., & Hedman-Lagerlöf, E. (2023) · Figshare · doi:10.6084/m9.figshare.24098307
Self-citationXu, J., Shen, J., Wang, J., & Huang, G. (2026) · doi:10.2196/preprints.91108
Somatic Symptom Disorder and Illness Anxiety Disorder
Pilipenko, N., Desai, K. M., & Garcia, A. V. (2026) · Springer eBooks · doi:10.1007/978-3-032-12819-5_2
Lai, L., Liu, Y., Axelsson, E., Tyrer, P., Li, Y., Lu, Y., Shi, C., & Ren, Z. (2026) · The British Journal of Psychiatry · doi:10.1192/bjp.2026.10647
Self-citationSmakowski, A., Löwe, B., Pauls, F., Hahn, S., Blankenburg, K., Maehder, K., Nestoriuc, Y., & Toussaint, A. C. (2026) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2026.112916
Jutzi, F. K., Witthöft, M., Baumeister, H., Denninger, M., Rief, W., Bleichhardt, G. M., Bailer, J., Kirsch, P., Erkic, M., Mier, D. U., et al. (2026) · Trials · doi:10.1186/s13063-026-09886-y
Analysis of health anxiety trajectories in rabies exposure patients based on machine learning
Ma, Y., Xie, H., Liu, X., Lu, B., Jiang, M., 莫诚航, Li, H., Li, F., Liang, L., & Xiong, G. (2026) · BMC Public Health · doi:10.1186/s12889-026-28507-6
Hennemann, S., Fähnrich, J. M., Tietze, C., Witthöft, M., & Jungmann, S. M. (2026) · Digital Health · doi:10.1177/20552076261450336 · Cited by 1
Xu, J., Shen, J., Wang, J., & Huang, G. (2026) · JMIR mhealth and uhealth · doi:10.2196/91108
Cerazy, D., & Kraszewski, S. (2026) · doi:10.2196/preprints.115272
Metadata
- Authors
- Hedman, E., Axelsson, E., Andersson, E., Lekander, M., & Ljótsson, B.
- Affiliations
- Stockholm University (SE)
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-11
- Volume
- 209
- Issue
- 5
- Pages
- 407-413
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2494313366
- Cited by
- 119
- References
- 43
- Citations by year
- 2026: 12 · 2025: 7 · 2024: 13 · 2023: 10 · 2022: 13 · 2021: 6 · 2020: 14 · 2019: 17 · 2018: 14 · 2017: 11 · 2016: 2
- FWCI
- 22.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Karolinska Institutet
- Stockholms Läns Landsting
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- 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
- Keywords
- somatic symptom disorder, health anxiety, internet-based cognitive behavioral therapy, bibliotherapy, exposure therapy, treatment accessibility, DSM-5
- MeSH terms
- Adult, Aged, Bibliotherapy, Female, Follow-Up Studies, Humans, Hypochondriasis, Implosive Therapy, Male, Middle Aged, Psychophysiologic Disorders, Somatoform Disorders, Cognitive Behavioral Therapy, Outcome Assessment, Health Care, Internet, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
