Efficacy of internet-based psychological interventions for pathological health anxiety: A three-level meta-analysis of randomized controlled trials

OBJECTIVE

This study aimed to provide a comprehensive summary and synthesis of available evidence on the efficacy of internet-based psychological interventions for pathological health anxiety, as well as to examine the variables that possibly moderate intervention effects.

METHOD

Four databases were searched for the literature up to October 2023. A three-level random-effects model was used to estimate the pooled effect size, with Hedge's g as the measure.

RESULTS

We extracted 28 effect sizes from nine eligible randomized controlled trials with 1079 participants. The results showed that internet-based psychological interventions had a moderate to large between-group effect on health anxiety (g = 0.70) that was significant both at post-intervention (g = 0.74) and follow-up (g = 0.64). Furthermore, these interventions were significantly more effective than passive control conditions including waitlist, usual care, and placebo at post-treatment (g = 1.07), but had effects comparable to active control groups at both post-intervention and follow-up.

CONCLUSIONS

Internet-based psychological interventions are an effective way to alleviate pathological health anxiety. We recommend that these interventions be more widely implemented in routine care settings to ensure easy accessibility for patients with health anxiety.

Exposure therapy for health anxiety: Effectiveness and response rates in routine care of an outpatient clinic

OBJECTIVE

Many randomized controlled trials (RCTs) have demonstrated the efficacy and benefits of exposure therapy in the treatment of health anxiety. However, the application of these research results to routine care has not been considered sufficiently. The aim of this study is to analyze the effectiveness of exposure therapy in the routine treatment of health anxiety patients.

METHOD

Data were available for 35 patients, who repeatedly filled in comprehensive general questionnaires, and those specific to health anxiety.

RESULTS

The data analysis showed that health anxiety symptoms decreased significantly both posttreatment (Cohen's d = 0.97-1.00) and at follow-up (Cohen's d = 1.33-1.34). In addition, the scores of depressiveness, somatic symptoms, and psychological distress showed improvements with effect sizes of d = 0.35-0.51. Regarding the primary outcome measures for health anxiety, response rates were 51%-63%, and remission rates were 29%-43%.

CONCLUSION

Exposure therapy is effective and sustainable regarding the treatment of health anxiety, even under naturalistic conditions, whereas response and remission rates are lower than for RCT.