Antidepressant, counseling may help hypochondriacs

NEW YORK (Reuters Health) - Cognitive behavior therapy and treatment with the antidepressant paroxetine, better known as Paxil or Seroxat, may both be effective short-term treatments for people with an excessive concern about illness, according to Dutch researchers.

They note in the American Journal of Psychiatry that hypochondriasis can be can be quite distressing, as sufferers think they are seriously ill despite medical reassurance. Their fears can affect their well-being and work performance, and can be difficult to treat.

In a multicenter trial, Dr. Philip Spinhoven, of Leiden University Medical Center, and colleagues assigned 112 patients with hypochondriasis to cognitive behavior therapy, paroxetine or placebo treatment.

The primary outcome was determined using a standard self-report questionnaire designed to assess the core features of hypochondriasis. The patients were evaluated at baseline and at 16 weeks. Thirty patients dropped out early, leaving 82 who completed the study.

The team found that the response to treatment was significantly better for participants who received cognitive behavior therapy or paroxetine than those assigned to placebo.

Specifically, 54 percent of cognitive behavior therapy patients responded well, as did 38 percent of paroxetine patients, compared with just 12 percent of placebo patients.

"After these treatments, subjects appeared to be less frequently and intensively preoccupied with their fears of having a serious disease and also had less associated depressive, anxious, and psychoneurotic symptoms," Spinhoven's team reports.

SOURCE: American Journal of Psychiatry, January 2007.