Articlehybrid2012

A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis).

Freda V. McManus · Christina Surawy · Kate Muse · Maria Vazquez-Montes · J. Mark G. Williams

179 citations0/0 files storedJournal of Consulting and Clinical Psychology

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Mindfulness and Compassion Interventions Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Psychosomatic Disorders and Their Treatments

Abstract

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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References

2013Diagnostic and Statistical Manual of Mental Disorders 2000Diagnostic and Statistical Manual of Mental Disorders.1988An inventory for measuring clinical anxiety: Psychometric properties.2004Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods 1984Essentials of Behavioral Research: Methods and Data Analysis 2010The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review.2001Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse 2000Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy.

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2018Reporting of Treatment Fidelity in Mindfulness-Based Intervention Trials: A Review and New Tool Using NIH Behavior Change Consortium Guidelines 2016The Influence of Attrition in Evaluating the Efficacy and Effectiveness of Mindfulness-Based Interventions 2011Mindfulness‐based cognitive therapy for severe health anxiety (hypochondriasis): An interpretative phenomenological analysis of patients’ experiences 2015Acceptance and commitment group therapy (ACT-G) for health anxiety: a randomized controlled trial

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