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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 f33 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. Declaration of interest P.S. adapted the CBT intervention for health anxiety and developed the Health Anxiety Inventory. P.T. is the Editor of the British Journal of Psychiatry but had no part in the evaluation of this paper for publication. Funding and trial registration detailed in Acknowledgements.

Original publication




Journal article


British Journal of Psychiatry

Publication Date





332 - 337