Cognitive–behaviour therapy for health anxiety in medical patients (CHAMP): a randomised controlled trial with outcomes to 5 years
| Autor: | Peter Tyrer, Paul Salkovskis, Helen Tyrer, Duolao Wang, Michael J Crawford, Simon Dupont, Sylvia Cooper, John Green, David Murphy, Georgina Smith, Sharandeep Bhogal, Shaeda Nourmand, Valentina Lazarevic, Gemma Loebenberg, Rachel Evered, Stephanie Kings, Antoinette McNulty, Yvonne Lisseman-Stones, Sharon McAllister, Kofi Kramo, Jessica Nagar, Steven Reid, Rahil Sanatinia, Katherine Whittamore, Gemma Walker, Aaron Philip, Hilary Warwick, Sarah Byford, Barbara Barrett |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: | |
| Zdroj: | Health Technology Assessment, Vol 21, Iss 50 (2017) |
| Druh dokumentu: | article |
| ISSN: | 1366-5278 2046-4924 |
| DOI: | 10.3310/hta21500 |
| Popis: | Background: Health anxiety is an under-recognised but frequent cause of distress that is potentially treatable, but there are few studies in secondary care. Objective: To determine the clinical effectiveness and cost-effectiveness of a modified form of cognitive–behaviour therapy (CBT) for health anxiety (CBT-HA) compared with standard care in medical outpatients. Design: Randomised controlled trial. Setting: Five general hospitals in London, Middlesex and Nottinghamshire. Participants: A total of 444 patients aged 16–75 years seen in cardiology, endocrinology, gastroenterology, neurology and respiratory medicine clinics who scored ≥ 20 points on the Health Anxiety Inventory (HAI) and satisfied diagnostic requirements for hypochondriasis. Those with current psychiatric disorders were excluded, but those with concurrent medical illnesses were not. Interventions: Cognitive–behaviour therapy for health anxiety – between 4 and 10 1-hour sessions of CBT-HA from a health professional or psychologist trained in the treatment. Standard care was normal practice in primary and secondary care. Main outcome measures: Primary – researchers masked to allocation assessed patients at baseline, 3, 6, 12, 24 months and 5 years. The primary outcome was change in the HAI score between baseline and 12 months. Main secondary outcomes – costs of care in the two groups after 24 and 60 months, change in health anxiety (HAI), generalised anxiety and depression [Hospital Anxiety and Depression Scale (HADS)] scores, social functioning using the Social Functioning Questionnaire and quality of life using the EuroQol-5 Dimensions (EQ-5D), at 6, 12, 24 and 60 months, and deaths over 5 years. Results: Of the 28,991 patients screened over 21 months, 5769 had HAI scores of ≥ 20 points. Improvement in HAI scores at 3 months was significantly greater in the CBT-HA group (mean number of sessions = 6) than in the standard care, and this was maintained over the 5-year period (overall p |
| Databáze: | Directory of Open Access Journals |
| Externí odkaz: |
|