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Some evidence of efficacy but CBT not the answer to mental health needs in general hospitals
  1. Christopher Williams1,
  2. Allan House2
  1. 1University of Glasgow, Institute of Health and Wellbeing, Glasgow, UK
  2. 2Leeds Institute of Health Sciences, University of Leeds, UK
  1. Correspondence to Professor Christopher Williams, chris.williams{at}

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What is already known on this topic?

Anxiety and health anxiety are commonly seen in medical general settings. Health anxiety focuses on the fear of disease that is not present or is less severe than feared, and is common—up to 15–20% of cases in medical hospitals.1 Cognitive behavioural therapy (CBT) is recommended however access is often limited,2 hence an interest in whether CBT can be delivered in shortened and manualised ways.

What this paper adds?

  • A short, low-intensity and easily delivered intervention may be effective for the health anxiety seen in general medical clinics.

  • Non-CBT experts were trained in just two sessions to deliver 5–10 sessions of manualised CBT treatment.

  • Scores of a health anxiety symptoms inventory improved, and costs were no different from usual care.


  • Screening of over 28 000 patients attending a hospital-based medical clinic led to the recovery of just 14 people who would not have got better with routine care.

  • The cost of screening was not included in the analysis. Combined with a lack of effect on quality of life raises a question about cost-effectiveness.

  • The study seems to lack high users of services—with …

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  • Competing interests CW was the past president of the lead body for CBT in the UK––the British Association for Behavioural and Cognitive Psychotherapies (BABCP). He is also the author of a range of guided self-help resources addressing a variety of mental and physical health conditions, for which he receives royalty, and is Director of a company which markets a range of CBT based approaches. AH has no competing interests.