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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?


Embedded ImageDesign:

Randomised controlled trial.

Embedded ImageAllocation:


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% …

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  • For correspondence: Dr Spinhoven, PO Box 9555, 2300 RB Leiden; spinhoven{at}

  • Source of funding: Unconditional educational grant from GlaxoSmithKline.


  • Competing interests: None declared.