Abstract
•We evaluated the feasibility of delivering MCT for health anxiety and to collect pilot data on the treatment's preliminary efficacy as measured by the whiteley index.•MCT was found to be feasible and acceptable for individuals with health anxiety, with clinically significant changes and large effects (Hedges’ g = 3.18).•The results support continued evaluation of MCT in health anxiety and a large-scale randomised trial is supported.
Health anxiety is a pervasive mental health condition, in which people worry about having or developing a serious illness or disease. Cognitive behavioural therapy (CBT) is currently considered the most researched psychological treatment for health anxiety, although several systematic reviews and meta-analysis have shown mixed findings for its efficacy. More efficacious interventions that can be easily integrated within services are required. An alternative to CBT, that has proven more effective in some other disorders, is metacognitive therapy (MCT). The aim was to evaluate the feasibility of delivering MCT for health anxiety and to collect pilot data on the treatment's preliminary efficacy.
Twenty participants with health anxiety were recruited to an open randomized feasibility trial and randomized to MCT or waitlist control. Acceptability and feasibility of MCT was based on recruitment rates, withdrawal, and drop-out, number of MCT sessions attended, completion of questionnaires, and any adverse reactions observed. The study was also used to evaluate initial treatment effects.
MCT was found to be feasible and acceptable for individuals with health anxiety. Recruitment and retention of all participants was high, and no adverse events were observed in either group. Pre to post between group effect sizes on the primary outcome measure The Whiteley Index (Pilowsky, 1967) were large (Hedges’ g = 3.18-Mdiff= 26.2, [95 % CI=18.7–33.6]) in favour of MCT. Clinically significant recovery rates were 80 % at post treatment and follow up.
The results suggest that a trial of MCT was acceptable and feasible in individuals with health anxiety and the treatment effects were statistically significant in comparison to the waiting list. Based upon the design used in this study MCT should be compared with active treatments such as medication, treatment as usual or specific cognitive behaviour therapy protocols in a future definitive randomised trial.