title: Internet-delivered exposure-based cognitive-behavioural therapy and behavioural stress management for severe health anxiety: randomised controlled trial.
abstract: BACKGROUND
  Exposure-based cognitive-behavioural therapy (CBT) delivered via the internet has been shown to be effective for severe health anxiety (hypochondriasis) but has not been compared with an active, effective and credible psychological treatment, such as behavioural stress management (BSM).
  
  
  OBJECTIVE
  To investigate two internet-delivered treatments - exposure-based CBT v. BSM - for severe health anxiety in a randomised controlled trial (trial registration: NCT01673035).
  
  
  METHODS
  Participants (n = 158) with a principal diagnosis of severe health anxiety were allocated to 12 weeks of exposure-based CBT (n = 79) or BSM (n = 79) delivered via the internet. The Health Anxiety Inventory (HAI) was the primary outcome.
  
  
  RESULTS
  Internet-delivered exposure-based CBT led to a significantly greater improvement on the HAI compared with BSM. However, both treatment groups made large improvements on the HAI (pre-to-post-treatment Cohen's d: exposure-based CBT, 1.78; BSM, 1.22).
  
  
  CONCLUSIONS
  Exposure-based CBT delivered via the internet is an efficacious treatment for severe health anxiety.
authors.affiliation: Erik Hedman, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, and Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Erland Axelsson, MSc, Anders Görling, MSc, Carina Ritzman, MSc, Markus Ronnheden, MSc, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Samir El Alaoui, MSc, Erik Andersson, MSc, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; Mats Lekander, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, and Stress Research Institute, Stockholm University, Stockholm; Brjánn Ljótsson, PhD, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Hedman
authors.affiliation: Erik Hedman, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, and Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Erland Axelsson, MSc, Anders Görling, MSc, Carina Ritzman, MSc, Markus Ronnheden, MSc, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Samir El Alaoui, MSc, Erik Andersson, MSc, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; Mats Lekander, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, and Stress Research Institute, Stockholm University, Stockholm; Brjánn Ljótsson, PhD, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Erland
authors.initials: E
authors.lastname: Axelsson
authors.affiliation: Erik Hedman, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, and Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Erland Axelsson, MSc, Anders Görling, MSc, Carina Ritzman, MSc, Markus Ronnheden, MSc, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Samir El Alaoui, MSc, Erik Andersson, MSc, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; Mats Lekander, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, and Stress Research Institute, Stockholm University, Stockholm; Brjánn Ljótsson, PhD, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Görling
authors.affiliation: Erik Hedman, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, and Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Erland Axelsson, MSc, Anders Görling, MSc, Carina Ritzman, MSc, Markus Ronnheden, MSc, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Samir El Alaoui, MSc, Erik Andersson, MSc, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; Mats Lekander, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, and Stress Research Institute, Stockholm University, Stockholm; Brjánn Ljótsson, PhD, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Ritzman
authors.affiliation: Erik Hedman, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, and Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Erland Axelsson, MSc, Anders Görling, MSc, Carina Ritzman, MSc, Markus Ronnheden, MSc, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Samir El Alaoui, MSc, Erik Andersson, MSc, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; Mats Lekander, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, and Stress Research Institute, Stockholm University, Stockholm; Brjánn Ljótsson, PhD, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Markus
authors.initials: M
authors.lastname: Ronnheden
authors.affiliation: Erik Hedman, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, and Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Erland Axelsson, MSc, Anders Görling, MSc, Carina Ritzman, MSc, Markus Ronnheden, MSc, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Samir El Alaoui, MSc, Erik Andersson, MSc, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; Mats Lekander, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, and Stress Research Institute, Stockholm University, Stockholm; Brjánn Ljótsson, PhD, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Samir
authors.initials: S
authors.lastname: El Alaoui
authors.affiliation: Erik Hedman, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, and Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Erland Axelsson, MSc, Anders Görling, MSc, Carina Ritzman, MSc, Markus Ronnheden, MSc, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Samir El Alaoui, MSc, Erik Andersson, MSc, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; Mats Lekander, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, and Stress Research Institute, Stockholm University, Stockholm; Brjánn Ljótsson, PhD, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Andersson
authors.affiliation: Erik Hedman, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, and Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Erland Axelsson, MSc, Anders Görling, MSc, Carina Ritzman, MSc, Markus Ronnheden, MSc, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Samir El Alaoui, MSc, Erik Andersson, MSc, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; Mats Lekander, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, and Stress Research Institute, Stockholm University, Stockholm; Brjánn Ljótsson, PhD, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Lekander
authors.affiliation: Erik Hedman, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, and Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Erland Axelsson, MSc, Anders Görling, MSc, Carina Ritzman, MSc, Markus Ronnheden, MSc, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm; Samir El Alaoui, MSc, Erik Andersson, MSc, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; Mats Lekander, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, and Stress Research Institute, Stockholm University, Stockholm; Brjánn Ljótsson, PhD, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Brjánn
authors.initials: B
authors.lastname: Ljótsson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D006998:Hypochondriasis / Q000534:rehabilitation*; D020407:Internet; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000534:rehabilitation*; D016896:Treatment Outcome; D055815:Young Adult