BOSTON – It is estimated that about four to six percent of all primary care patients are affected by severe hypochondria, a persistent fear or belief that one has a serious, undiagnosed medical illness. In the first major U.S. trial to test a specific therapy for hypochondria – a condition that currently has no widely accepted treatment -- researchers from Brigham and Women’s Hospital (BWH) found that psychological therapy significantly improves a patient’s symptoms, fears and overall quality of life. The study appears in the March 24, 2004 issue of the Journal of the American Medical Association.
“Hypochondria is a common, chronic and debilitating condition, but no specific intervention has proven to be clinically effective in treating it, largely due to our lack of understanding and research in this area,” said Arthur Barsky, MD, BWH’s director of Psychiatric Research. “Our data shows that cognitive behavioral therapy is a tool physicians can use to care for these patients, making a marked difference in how they feel and act.”
Patients suffering from hypochondria complain of chronic pain, fatigue, dizziness and other bodily symptoms, yet doctors cannot find a medical basis for their ailments. Hypochondria results in psychological distress, missed days of work and strained relationships, adding to an overall decreased quality of life. The condition also influences healthcare costs, with some estimates suggesting that unexplained medical symptoms account for a $150 billion drain on the medical system each year in the United States.
In the BWH study, researchers compared two groups of patients suffering from hypochondria. One group of 102 patients participated in an experimental, six-session cognitive behavioral treatment (CBT) program. The primary care physicians assigned to these patients also received a special letter that outlined treatment recommendations and offered the physicians advice on how to care for and approach the patient during upcoming office visits. A control group of 80 patients was followed for the same period of time, but this group did not undergo the CBT therapy and their doctors did not receive the letter. After one year, the group undergoing therapy showed a significant improvement in symptoms compared to the patients who received the usual medical care. They reported feeling better and had fewer symptoms and less anxiety about their health. They were also found to have improved social functioning and improved functioning in their daily activities, such as doing errands and working around the house.
“In treating hypochondria, our first goal is not to cure the symptoms, but to care for the patients,” said Barsky, also Professor of Psychiatry at Harvard Medical School. “Based on this notion, we now have solid data demonstrating that a specific, focused treatment can offer long-term benefits to a population that has been somewhat lost in our healthcare system and until now, often left without accepted treatment options.”
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