Cognitive Behaviour Therapy for Health Anxiety: A Systematic Review and Meta-Analysis

Behav Cogn Psychother. 2017 Mar;45(2):110-123. doi: 10.1017/S1352465816000527.


Background: Health anxiety (HA), or hypochondriasis, is a psychological problem characterized by a preoccupation with the belief that one is physically unwell. A 2007 Cochrane review (Thomson and Page, 2007) found cognitive behavioural therapy (CBT) to be an effective intervention for individuals with HA. Similar findings were reported in a recent meta-analysis (Olatunji et al., 2014), which did not employ a systematic search strategy. The current review aimed to investigate the efficacy of CBT for HA, and to update the existing reviews.

Method: A systematic search was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance, including randomized controlled trials that compared CBT with a control condition for people with HA. Five hundred and sixty-seven studies were found in the original search, of which 14 were included in the meta-analysis.

Results: Meta-analysis was conducted on 21 comparisons and a large effect size for CBT compared with a control condition was found at post therapy d = 1.01 (95% confidence interval 0.77-1.25), as well as at 6- and 12-month follow-up.

Conclusions: This systematic review and meta-analysis provides support for the hypothesis that CBT is an effective intervention for HA when compared with a variety of control conditions, e.g. treatment-as-usual, waiting list, medication, and other psychological therapies.

Keywords: Hypochondriasis; cognitive behavioural therapy; health anxiety; meta-analysis; systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Anxiety
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy
  • Cognitive Behavioral Therapy / methods*
  • Humans
  • Hypochondriasis / psychology*
  • Hypochondriasis / therapy*
  • Psychotherapy / methods