Cognitive therapy versus exposure therapy for hypochondriasis (health anxiety): A randomized controlled trial.
Cognitive therapy versus exposure therapy for hypochondriasis (health anxiety): A randomized controlled trial.
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认知疗法与暴露疗法治疗疑病症（健康焦虑）：一项随机对照试验
DOI：
10.1037/ccp0000013
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发表时间：
2015
影响因子：
5.9
通讯作者：
Stangier
中科院分区：
文献类型：
--
作者：
J. M. B;Richtberg;Stangier
目的认知行为疗法是治疗疑病症和健康焦虑的有效方法。然而，人们对哪种治疗干预措施最有希望知之甚少。本研究的目的是比较认知疗法（CT）和暴露疗法（ET）的疗效。方法84例诊断为疑病症的患者随机分为CT组、ET组和等候名单对照组。主要结果测量是一个标准化的访谈，评估疑病症认知以及由独立诊断医生进行的行为。几个自我报告问卷被评估为次要结果测量。在治疗后和1年随访时评估治疗成功。结果CT （Hedges 's g= 1.01-1.11）和ET （Hedges 's g= 1.21-1.24）在主要结局测量中均比WL有效。此外，与WL相比，两种治疗在次要结果测量中均显著减少了抑郁症状和身体不适，但焦虑症状仅被ET显著减少。在直接比较中，CT和ET在主要或次要结果测量中未发现显著差异。在安全行为方面，我们发现在完整的分析中，ET比CT有更大的改善。结论CT与ET联合治疗疑病症疗效显著。认知干预不是功能失调认知改变的必要条件。这些发现与疑病症和健康焦虑的概念化和心理治疗有关。
ObjectiveCognitive–behavioral therapy has proven to be highly effective in the treatment of hypochondriasis and health anxiety. However, little is known about which therapeutic interventions are most promising. The aim of the present study was to compare the efficacy of cognitive therapy (CT) with exposure therapy (ET).MethodEighty-four patients with a diagnosis of hypochondriasis were randomly allocated to CT, ET, or a waiting list (WL) control group. The primary outcome measure was a standardized interview that evaluated hypochondriacal cognitions as well as behaviors conducted by independent diagnosticians. Several self-report questionnaires were evaluated as secondary outcome measures. Treatment success was evaluated at posttreatment and at 1-year follow-up.ResultsBoth CT (Hedges’s g= 1.01–1.11) and ET (Hedges’s g= 1.21–1.24) demonstrated their efficacy in comparison with the WL in the primary outcome measure. Moreover, a significant reduction in depressive symptoms and bodily complaints was found in the secondary outcome measures for both treatments in comparison with the WL, but anxiety symptoms were only significantly reduced by ET. In a direct comparison, no significant differences were found between CT and ET in the primary or the secondary outcome measures. Regarding safety behaviors, we found a significantly larger improvement with ET than with CT in the completer analyses.ConclusionsThe results suggest high efficacy of CT as well as ET in the treatment of hypochondriasis. Cognitive interventions were not a necessary condition for the change of dysfunctional cognitions. These findings are relevant to the conceptualization and psychotherapeutic treatment of hypochondriasis and health anxiety.
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影响因子：
4.1
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