علائم اضطراب سلامت در اختلال وسواس: ارتباط با نتیجه درمان و فراشناخت

The study aimed to examine symptoms of health anxiety in relation to obsessive–compulsive disorder (OCD), the effect health anxiety has on OCD treatment outcome, and how OCD treatment affects health anxiety symptoms. Another objective of the study was to explore the role of metacognition in symptoms of health anxiety. A sample of 313 patients with a primary diagnosis of OCD and 382 community controls were compared on the Whiteley Index (WI), the Metacognitions Questionnaire, and the Yale–Brown Obsessive–Compulsive Scale. Results showed that 30.4% in the OCD sample scored above an established cut-off for health anxiety on the WI, significantly higher than in the control group. Furthermore, health anxiety did not have a significant effect on OCD treatment outcome. Health anxiety improved moderately following OCD treatment. Finally, symptoms of health anxiety were found to be moderately correlated with metacognition and improvement in health anxiety was associated with changes in metacognitive beliefs. Implications for treatment and future research are discussed.

The prevalence of health anxiety has been shown to range from 5.7% in community samples (Sunderland, Newby, & Andrews, 2013), to 17.5% to 24.7% in medical settings (Tyrer et al., 2011). Findings on the prevalence of the extreme form of health anxiety i.e. hypochondriasis, in obsessive–compulsive disorder (OCD) are inconclusive, but the most recent and methodological robust studies suggest a prevalence rate of 10–17%, significantly higher than that in controls (Bienvenu et al., 2000, Fallon et al., 2000, Jaisoorya et al., 2003 and Savron et al., 1996). The relatively high prevalence rate, reluctance to accept referral to psychiatric clinics, and excessive health care utilization have made health anxiety a social concern both from a public health, and cost-effectiveness perspective (Greeven et al., 2007).