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Title: Prevalence and treatment of health anxiety in genitourinary medicine
Author: Seivewright, Helen
ISNI:       0000 0004 2691 1902
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2010
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The concepts of hypochondriasis and health anxiety are described in historical and modern contexts and justification given for the preferred usage of health anxiety, with the condition better classified with the anxiety disorders. The prevalence of hypochondriasis is reviewed and it is noted that most of the data are in primary care with only one paper from genitourinary medicine. The treatments for health anxiety and hypochondriasis are reviewed and noted, until recently, to be relatively limited in efficacy. A prevalence study of health anxiety in genitourinary medicine in two centres found that 8‐ 11% of attenders had significant health anxiety recorded by the Health Anxiety Inventory; that symptoms persisted over a 9 month period, and were associated with higher numbers of medical consultations. This was followed by a randomised controlled trial in a genitourinary medicine clinic in which an adapted form of cognitive behaviour therapy was given by me as a medical practitioner, and compared with a single explanatory interview in a control group. Assessments of clinical symptoms, social functioning and costs were made at baseline, 3, 6 and 12 months after randomisation. In 49 patients allocated, greater improvement was seen for the primary outcome of Health Anxiety Inventory (HAI) scores 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 the secondary outcomes of generalised anxiety, depression and social function, and there were fewer health service consultations. These differences were maintained in the six months after treatment was completed. The treatment costs were only partly offset by the savings in clinic appointments and for every unit reduction in HAI score there was an incremental cost of £33. It is concluded that the treatment, given in this manner, has the potential to be generalised.
Supervisor: Tyrer, Peter Sponsor: Sir Jules Thorne Charitable Trust ; Nicola Pigott Memorial Fund
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral