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Cognitive behavioural therapy increases response in people with hypochondriasis

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 Q Are cognitive behavioural therapy and paroxetine more effective than placebo for hypochondriasis?

METHOD

Embedded ImageDesign:

Randomised controlled trial.

Embedded ImageAllocation:

Concealed.

Embedded ImageBlinding:

Double blind (paroxetine and pill placebo groups only, blinding for cognitive behavioural therapy (CBT) group not described).

Embedded ImageFollow-up period:

Sixteen weeks.

Embedded ImageSetting:

Three psychiatric outpatient units in the Netherlands; January 1998 to July 2002.

Embedded ImagePatients:

112 adults (aged over 18 years) with hypochondriasis (DSM-IV). Main exclusions: severe comorbidity; substance abuse; diagnosis of anxiety or depression; use of antidepressants, antipsychotics or anticoagulants; already receiving psychotherapy; pregnancy or breastfeeding.

Embedded ImageIntervention:

CBT (6–16 individual sessions as needed), paroxetine (up to 60 mg daily), or pill placebo for 16 weeks.

Embedded ImageOutcomes:

Symptoms of hypochondriasis (4-point Likert scale version of the Whiteley Index); response (Jacobson and Truax criteria).

Embedded ImagePatient follow-up:

73% completed treatment (75% of CBT group; 70% of paroxetine group; 74% of placebo group); 97% included in last observation carried forward analyses.

MAIN RESULTS

Pooling results for CBT and paroxetine showed significantly improved symptoms compared with placebo (mean …

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