Impact of personality status on the outcomes and cost of cognitive-behavioural therapy for health anxiety.

Rahil Sanatinia, Duolao Wang, Peter Tyrer, Helen Tyrer, Mike Crawford, Sylvia Cooper, Gemma Loebenberg, Barbara Barrett

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)

Abstract

BACKGROUND

Health anxiety, hypochondriasis and personality disturbance commonly coexist. The impact of personality status was assessed in a secondary analysis of a randomised controlled trial (RCT).

AIMS

To 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.

METHOD

Personality dysfunction was assessed at baseline in 444 patients before randomisation and independent assessment of costs and outcomes made on four occasions over 2 years.

RESULTS

In 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.

CONCLUSIONS

The results contradict the hypothesis that personality disorder impairs response to CBT in health anxiety in both the short and medium term.

Original languageEnglish
Pages (from-to)244-250
Number of pages7
JournalBritish Journal of Psychiatry
Volume209
Issue number3
DOIs
Publication statusPublished - 21 Jul 2016

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