scholarly journals Impact of personality status on the outcomes and cost of cognitive–behavioural therapy for health anxiety

2016 ◽  
Vol 209 (3) ◽  
pp. 244-250 ◽  
Author(s):  
Rahil Sanatinia ◽  
Duolao Wang ◽  
Peter Tyrer ◽  
Helen Tyrer ◽  
Mike Crawford ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Cognitive Behavioural Therapy ◽  
Standard Care ◽  
Controlled Trial ◽  
Health Anxiety ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Personality Dysfunction ◽  
The Impact ◽  
Severe Personality Disorder

BackgroundHealth anxiety, hypochondriasis and personality disturbance commonly coexist. The impact of personality status was assessed in a secondary analysis of a randomised controlled trial (RCT).AimsTo test the impact of personality status using ICD-11 criteria on the clinical and cost outcomes of treatment with cognitive–behavioural therapy for health anxiety (CBT-HA) and standard care over 2 years.MethodPersonality dysfunction was assessed at baseline in 444 patients before randomisation and independent assessment of costs and outcomes made on four occasions over 2 years.ResultsIn total, 381 patients (86%) had some personality dysfunction with 184 (41%) satisfying the ICD criteria for personality disorder. Those with no personality dysfunction showed no treatment differences (P= 0.90) and worse social function with CBT-HA compared with standard care (P<0.03) whereas all other personality groups showed greater improvement with CBT-HA maintained over 2 years (P<0.001). Less benefit was shown in those with more severe personality disorder (P<0.05). Costs were less with CBT-HA except for non-significant greater differences in those with moderate or severe personality disorder.ConclusionsThe results contradict the hypothesis that personality disorder impairs response to CBT in health anxiety in both the short and medium term.

scholarly journals Protocol investigating the clinical outcomes and cost-effectiveness of cognitive–behavioural therapy delivered remotely for unscheduled care users with health anxiety: randomised controlled trial

BJPsych Open ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 81-87 ◽  
Author(s):  
Shireen Patel ◽  
Sam Malins ◽  
Boliang Guo ◽  
Marilyn James ◽  
Joe Kai ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Clinical Outcomes ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Health Anxiety ◽  
Behavioural Therapy ◽  
Unscheduled Care ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundHealth anxiety and medically unexplained symptoms cost the National Health Service (NHS) an estimated £3 billion per year in unnecessary costs with little evidence of patient benefit. Effective treatment is rarely taken up due to issues such as stigma or previous negative experiences with mental health services. An approach to overcome this might be to offer remotely delivered psychological therapy, which can be just as effective as face-to-face therapy and may be more accessible and suitable.AimsTo investigate the clinical outcomes and cost-effectiveness of remotely delivered cognitive–behavioural therapy (CBT) to people with high health anxiety repeatedly accessing unscheduled care (trial registration: NCT02298036).MethodA multicentre randomised controlled trial (RCT) will be undertaken in primary and secondary care providers of unscheduled care across the East Midlands. One hundred and forty-four eligible participants will be equally randomised to receive either remote CBT (6–12 sessions) or treatment as usual (TAU). Two doctoral research studies will investigate the barriers and facilitators to delivering the intervention and the factors contributing to the optimisation of therapeutic outcome.ResultsThis trial will be the first to test the clinical outcomes and cost-effectiveness of remotely delivered CBT for the treatment of high health anxiety.ConclusionsThe findings will enable an understanding as to how this intervention might fit into a wider care pathway to enhance patient experience of care.

London–East Anglia randomised controlled trial of cognitive–behavioural therapy for psychosis

1997 ◽  
Vol 171 (4) ◽  
pp. 319-327 ◽  
Author(s):  
Elizabeth Kuipers ◽  
Philippa Garety ◽  
David Fowler ◽  
Graham Dunn ◽  
Paul Bebbington ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Cognitive Behavioural Therapy ◽  
Standard Care ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Psychotic Symptoms ◽  
Control Group ◽  
Improve Outcome ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundA series of small, mainly uncontrolled, studies have suggested that techniques adapted from cognitive–behavioural therapy (CBT) for depression can improve outcome in psychosis, but no large randomised controlled trial of intensive treatment for medication-resistant symptoms of psychosis has previously been published.MethodSixty participants who each had at least one positive and distressing symptom of psychosis that was medication-resistant were randomly allocated between a CBT and standard care condition (n=28) and a standard care only control condition (n=32). Therapy was individualised, and lasted for nine months. Multiple assessments of outcome were used.ResultsOver nine months, improvement was significant only in the treatment group, who showed a 25% reduction on the BPRS. No other clinical, symptomatic or functioning measure changed significantly. Participants had a low drop-out rate from therapy (11%), and expressed high levels of satisfaction with treatment (80%). Fifty per cent of the CBT group were treatment responders (one person became worse), compared with 31% of the control group (three people became worse and another committed suicide)ConclusionsCBT for psychosis can improve overall symptomatology. The findings provide evidence that even a refractory group of clients with a long history of psychosis can engage in talking about psychotic symptoms and their meaning, and this can improve outcome.

scholarly journals Early Improvement in Eating Attitudes during Cognitive Behavioural Therapy for Eating Disorders: The Impact of Personality Disorder Cognitions

2013 ◽  
Vol 42 (2) ◽  
pp. 224-237 ◽  
Author(s):  
Emma C. Park ◽  
Glenn Waller ◽  
Kenneth Gannon
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Eating Attitudes ◽  
Drop Out ◽  
Cognitive Behavioural ◽  
The Impact

Background: The personality disorders are commonly comorbid with the eating disorders. Personality disorder pathology is often suggested to impair the treatment of axis 1 disorders, including the eating disorders. Aims: This study examined whether personality disorder cognitions reduce the impact of cognitive behavioural therapy (CBT) for eating disorders, in terms of treatment dropout and change in eating disorder attitudes in the early stages of treatment. Method: Participants were individuals with a diagnosed eating disorder, presenting for individual outpatient CBT. They completed measures of personality disorder cognitions and eating disorder attitudes at sessions one and six of CBT. Drop-out rates prior to session six were recorded. Results: CBT had a relatively rapid onset of action, with a significant reduction in eating disorder attitudes over the first six sessions. Eating disorder attitudes were most strongly associated with cognitions related to anxiety-based personality disorders (avoidant, obsessive-compulsive and dependent). Individuals who dropped out of treatment prematurely had significantly higher levels of dependent personality disorder cognitions than those who remained in treatment. For those who remained in treatment, higher levels of avoidant, histrionic and borderline personality disorder cognitions were associated with a greater change in global eating disorder attitudes. Conclusions: CBT's action and retention of patients might be improved by consideration of such personality disorder cognitions when formulating and treating the eating disorders.

scholarly journals Internet-assisted cognitive behavioural therapy with telephone coaching for anxious Finnish children aged 10–13 years: study protocol for a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045474
Author(s):  
Terhi Luntamo ◽  
Tarja Korpilahti-Leino ◽  
Terja Ristkari ◽  
Sanna Hinkka-Yli-Salomäki ◽  
Marjo Kurki ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Well Being ◽  
Childhood Anxiety ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Telephone Coaching ◽  
The Impact

IntroductionChildhood anxiety is common, causes significant functional impairment and may lead to psychosocial problems by adulthood. Although cognitive behavioural therapy (CBT) is effective for treating anxiety, its availability is limited by the lack of trained CBT therapists and easily accessible local services. To address the challenges in both recognition and treatment, this study combines systematic anxiety screening in the general population with a randomised controlled trial (RCT) on internet-assisted CBT (ICBT) with telephone coaching. Child, family and intervention-related factors are studied as possible predictors or moderators, together with the COVID-19 pandemic.Methods and analysisThe study is an open two-parallel group RCT, stratified by sex, that compares ICBT with telephone coaching to an education control. Children aged 10–13 are screened at yearly school healthcare check-ups using five items from the Screen for Child Anxiety Related Disorders (SCARED) Questionnaire. The families of children who screen positive for anxiety are contacted to assess the family’s eligibility for the RCT. The inclusion criteria include scoring at least 22 points in the 41-item SCARED Questionnaire. The primary outcome is the SCARED child and parent reports. The secondary outcomes include the impact of anxiety, quality of life, comorbidity, peer relationships, perceptions of school, parental well-being and service use. Additional measures include demographics and life events, anxiety disorder diagnoses, as well as therapeutic partnerships, the use of the programme and general satisfaction among the intervention group.Ethics and disseminationThe study has been approved by the research ethics board of the Hospital District of South West Finland and local authorities. Participation is voluntary and based on informed consent. The anonymity of the participants will be protected and the results will be published in a scientific journal and disseminated to healthcare professionals and the general public.Trial registration numberClinicalTrials.gov NCT03310489, pre-results, initially released on 30 September 2017.

scholarly journals Internet-delivered exposure-based cognitive–behavioural therapy and behavioural stress management for severe health anxiety: randomised controlled trial

2014 ◽  
Vol 205 (4) ◽  
pp. 307-314 ◽  
Author(s):  
Erik Hedman ◽  
Erland Axelsson ◽  
Anders Görling ◽  
Carina Ritzman ◽  
Markus Ronnheden ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Stress Management ◽  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Controlled Trial ◽  
Health Anxiety ◽  
Behavioural Therapy ◽  
The Internet ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundExposure-based cognitive–behavioural therapy (CBT) delivered via the internet has been shown to be effective for severe health anxiety (hypochondriasis) but has not been compared with an active, effective and credible psychological treatment, such as behavioural stress management (BSM).AimsTo investigate two internet-delivered treatments – exposure-based CBTv.BSM – for severe health anxiety in a randomised controlled trial (trial registration: NCT01673035).MethodParticipants (n= 158) with a principal diagnosis of severe health anxiety were allocated to 12 weeks of exposure-based CBT (n= 79) or BSM (n= 79) delivered via the internet. The Health Anxiety Inventory (HAI) was the primary outcome.ResultsInternet-delivered exposure-based CBT led to a significantly greater improvement on the HAI compared with BSM. However, both treatment groups made large improvements on the HAI (pre-to-post-treatment Cohen'sd: exposure-based CBT, 1.78; BSM, 1.22).ConclusionsExposure-based CBT delivered via the internet is an efficacious treatment for severe health anxiety.Declarations of interestNone.

scholarly journals Cognitive–behavioural therapy for health anxiety in a genitourinary medicine clinic: randomised controlled trial

2008 ◽  
Vol 193 (4) ◽  
pp. 332-337 ◽  
Author(s):  
Helen Seivewright ◽  
John Green ◽  
Paul Salkovskis ◽  
Barbara Barrett ◽  
Ula Nur ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Health Anxiety ◽  
Behavioural Therapy ◽  
Control Group ◽  
Medicine Clinic ◽  
Cognitive Behavioural ◽  
Genitourinary Medicine ◽  
Unit Reduction ◽  
Randomised Controlled

BackgroundLittle is known about the management of health anxiety and hypochondriasis in secondary care settings.AimsTo determine whether cognitive–behavioural therapy (CBT) along with a supplementary manual was effective in reducing symptoms and health consultations in patients with high health anxiety in a genitourinary medicine clinic.MethodPatients with high health anxiety were randomly assigned to brief CBT and compared with a control group.ResultsGreater improvement was seen in Health Anxiety Inventory (HAI) scores (primary outcome) in patients treated with CBT (n=23) than in the control group (n=26) (P=0.001). Similar but less marked differences were found for secondary outcomes of generalised anxiety, depression and social function, and there were fewer health service consultations. The CBT intervention resulted in improvements in outcomes alongside higher costs, with an incremental cost of £33 per unit reduction in HAI score.ConclusionsCognitive–behavioural therapy for health anxiety within a genitourinary medicine clinic is effective and suggests wider use of this intervention in medical settings.

scholarly journals Sleeping for Two: Study protocol for a randomized controlled trial of cognitive behavioural therapy for insomnia in pregnant women

2021 ◽  
Author(s):  
Anna L. MacKinnon ◽  
Joshua Madsen ◽  
Ashley Dhillon ◽  
Elizabeth Keys ◽  
Gerald Giesbrecht ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Cognitive Behavioural Therapy ◽  
Sleep Disturbances ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Control Group ◽  
Gestational Length ◽  
Cognitive Behavioural ◽  
The Impact ◽  
In Pregnancy

Insomnia and sleep disturbances are common in pregnancy and have potentially significant consequences for both maternal and infant health. There is limited research examining the effectiveness of cognitive behavioural therapy for insomnia (CBT-I) during pregnancy. With increased distress and limited access to services during the COVID-19 pandemic, there is also an unprecedented need for telehealth delivery of treatment programs for pregnant women. The primary aim of the trial is to evaluate the impact of in-person or telehealth cognitive behavioural therapy for insomnia (CBT-I) versus a treatment as usual (TAU) control group in reducing symptoms of insomnia experienced in pregnancy. We hypothesize that participants who receive CBT-I delivered in person or via telehealth will report fewer insomnia symptoms. The secondary aims are to investigate if CBT-I versus TAU increases gestational length and reduces symptoms of depression. We hypothesize that receiving CBT-I will be associated with longer gestational length (as confirmed by public health records) and lower depressive symptoms.

scholarly journals Internet-based cognitive–behavioural therapy for severe health anxiety: randomised controlled trial

2011 ◽  
Vol 198 (3) ◽  
pp. 230-236 ◽  
Author(s):  
Erik Hedman ◽  
Gerhard Andersson ◽  
Erik Andersson ◽  
Brjánn Ljótsson ◽  
Christian Rück ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Functional Disability ◽  
Controlled Trial ◽  
Health Anxiety ◽  
Behavioural Therapy ◽  
Primary Outcome Measure ◽  
Control Group ◽  
Cognitive Behavioural ◽  
Superiority Trial ◽  
Randomised Controlled

BackgroundHypochondriasis, characterised by severe health anxiety, is a common condition associated with functional disability. Cognitive–behavioural therapy (CBT) is an effective but not widely disseminated treatment for hypochondriasis. Internet-based CBT, including guidance in the form of minimal therapist contact via email, could be a more accessible treatment, but no study has investigated internet-based CBT for hypochondriasis.AimsTo investigate the efficacy of internet-based CBT for hypochondriasis.MethodA randomised controlled superiority trial with masked assessment comparing internet-based CBT (n= 40) over 12 weeks with an attention control condition (n= 41) for people with hypochondriasis. The primary outcome measure was the Health Anxiety Inventory. This trial is registrated with ClinicalTrials.gov (NCT00828152).ResultsParticipants receiving internet-based CBT made large and superior improvements compared with the control group on measures of health anxiety (between-group Cohen'sdrange 1.52–1.62).ConclusionsInternet-based CBT is an efficacious treatment for hypochondriasis that has the potential to increase accessibility and availability of CBT for hypochodriasis.

Sign in / Sign up

Export Citation Format

Share Document