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Published on: January 18, 2021
Exposure-based cognitive-behavioural therapy via the internet and as bibliotherapy for somatic symptom disorder and
Erik Hedman1, Erland Axelsson2, Erik Andersson2
1Erik Hedman, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine & Division of Psychology, Karolinska Institutet, Stockholm, Sweden; Erland Axelsson, MSc, Erik Andersson, PhD, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden; Mats Lekander, PhD, Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, and Stress Research Institute, Stockholm University, Stockholm, Sweden; Brjánn Ljósson, PhD, Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden kire.hedman@ki.se.
Background:
In DSM-5 two new diagnoses, somatic symptom disorder (SSD) and illness anxiety disorder (IAD), have replaced DSM-IV hypochondriasis. There are no previous treatment studies for these disorders. Cognitive-behavioural therapy (CBT) delivered as therapist-guided or unguided internet treatment or as unguided bibliotherapy could be used to increase treatment accessibility.
Aims:
To investigate the effect of CBT delivered as guided internet treatment (ICBT), unguided internet treatment (U-ICBT) and as unguided bibliotherapy.
Method:
A randomised controlled trial (RCT) where participants (n = 132) with a diagnosis of SSD or IAD were randomised to ICBT, U-ICBT, bibliotherapy or to a control condition on a waiting list (trial registration: Clinicaltrials.gov identifier NCT01966705).
Results:
Compared with the control condition, all three treatment groups made large and significant improvements on the primary outcome Health Anxiety Inventory (between-group d at post-treatment was 0.80-1.27).
Conclusions:
ICBT, U-ICBT and bibliotherapy can be highly effective in the treatment of SSD and IAD. This is the first study showing that these new DSM-5 disorders can be effectively treated.
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