Wednesday, March 31, 2004

Treating hypochondria with cognitive therapy

A New Era in Treating Imaginary Ills
New treatment strategies are offering the first hope since the ancient Greeks recognized hypochondria 24 centuries ago. Cognitive therapy, researchers reported last week, helps hypochondriacal patients evaluate and change their distorted thoughts about illness. After six 90-minute therapy sessions, the study found, 55 percent of the 102 participants were better able to do errands, drive and engage in social activities. Antidepressant medications, other studies indicate, are also proving effective.

'The hope is that with effective treatments, a diagnosis of hypochondriasis will become a more acceptable diagnosis and less a laughing matter or a cause for embarrassment,' said Dr. Arthur J. Barsky, director of psychiatric research at Brigham and Women's Hospital in Boston and the lead author of the study on cognitive therapy, which appeared in the March 24 issue of The Journal of the American Medical Association.

The great challenge of treating patients with hypochondria is that just when you convince them their headache is harmless they start seizing from their brain tumor.

The patients in this study were seriously disabled by their fears. I can't tell from the NYT article how big an impact the intervention had and what the control group experienced. This may or may not be a meaningful therapy or a significant change. It was a lot of interventions. Similar work is being tried on chronic pain, which has some similarities to the disabling features of hypochondria. It is not the "reality" of the underlying problem that really matters, but how the mind responds to what it experiences.

No comments: