title: CHAMP: Cognitive behaviour therapy for health anxiety in medical patients, a randomised controlled trial.
abstract: BACKGROUND
  Abnormal health anxiety, also called hypochondriasis, has been successfully treated by cognitive behaviour therapy (CBT) in patients recruited from primary care, but only one pilot trial has been carried out among those attending secondary medical clinics where health anxiety is likely to be more common and have a greater impact on services. The CHAMP study extends this work to examine both the clinical and cost effectiveness of CBT in this population.
  
  
  METHODS
  The study is a randomized controlled trial with two parallel arms and equal randomization of 466 eligible patients (assuming a 20% drop-out) to an active treatment group of 5-10 sessions of cognitive behaviour therapy and to a control group. The aim at baseline, after completion of all assessments but before randomization, was to give a standard simple explanation of the nature of health anxiety for all participants. Subsequently the control group was to receive whatever care might usually be available in the clinics, which is normally a combination of clinical assessment, appropriate tests and reassurance. Those allocated to the active treatment group were planned to receive between 5 and 10 sessions of an adapted form of cognitive behaviour therapy based on the Salkovskis/Warwick model, in which a set of treatment strategies are chosen aimed at helping patients understand the factors that drive and maintain health anxiety. The therapy was planned to be given by graduate research workers, nurses or other health professionals trained for this intervention whom would also have their competence assessed independently during the course of treatment. The primary outcome is reduction in health anxiety symptoms after one year and the main secondary outcome is the cost of care after two years.
  
  
  CONCLUSIONS
  This represents the first trial of adapted cognitive behaviour therapy in health anxiety that is large enough to test not only the clinical benefits of treatment but also whether the cost of treatment is offset by savings from reduced use of other health services in comparison to the control group.Cognitive behaviour therapy for Health Anxiety in Medical Patients (CHAMP) TRIAL REGISTRATION: Current Controlled Trials ISRCTN14565822.
authors.affiliation: Centre for Mental Health, Imperial College, UK. p.tyrer@imperial.ac.uk
authors.forename: Peter
authors.initials: P
authors.lastname: Tyrer
authors.forename: Sylvia
authors.initials: S
authors.lastname: Cooper
authors.forename: Helen
authors.initials: H
authors.lastname: Tyrer
authors.forename: Paul
authors.initials: P
authors.lastname: Salkovskis
authors.forename: Mike
authors.initials: M
authors.lastname: Crawford
authors.forename: John
authors.initials: J
authors.lastname: Green
authors.forename: Georgina
authors.initials: G
authors.lastname: Smith
authors.forename: Steven
authors.initials: S
authors.lastname: Reid
authors.forename: Simon
authors.initials: S
authors.lastname: Dupont
authors.forename: David
authors.initials: D
authors.lastname: Murphy
authors.forename: Sarah
authors.initials: S
authors.lastname: Byford
authors.forename: Duolao
authors.initials: D
authors.lastname: Wang
authors.forename: Barbara
authors.initials: B
authors.lastname: Barrett
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D006998:Hypochondriasis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment / Q000706:statistics & numerical data