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Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
 
BMC Psychiatry. 2011; 11: 99.
Published online Jun 14, 2011. doi:  10.1186/1471-244X-11-99
PMCID: PMC3141642
CHAMP: Cognitive behaviour therapy for health anxiety in medical patients, a randomised controlled trial
Peter Tyrer,corresponding author1 Sylvia Cooper,1 Helen Tyrer,1 Paul Salkovskis,2 Mike Crawford,1 John Green,3 Georgina Smith,3 Steven Reid,3 Simon Dupont,4 David Murphy,5 Sarah Byford,6 Duolao Wang,7 and Barbara Barrett6
1Centre for Mental Health, Imperial College, Claybrook Road London, W6 8LN, UK
2Department of Psychology, University of Bath, Bath, BA2 7AY, UK
3Central and North West London NHS Foundation Trust, Hampstead Road, London, NW1 7QY, UK
4Greenacres Centre, Hillingdon Hospital, Pield Heath Road, Uxbridge UB8 3NN, UK
5Department of Clinical Psychology, 10th Floor - West Wing, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
6Centre for the Economics of Mental Health, King's College London, De Crespigny Park, London SE5 8AF, UK
7Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
corresponding authorCorresponding author.
Peter Tyrer: p.tyrer/at/imperial.ac.uk; Sylvia Cooper: s.cooper/at/imperial.ac.uk; Helen Tyrer: h.tyrer/at/imperial.ac.uk; Paul Salkovskis: P.M.Salkovskis/at/bath.ac.uk; Mike Crawford: m.crawford/at/imperial.ac.uk; John Green: john.green/at/nhs.net; Georgina Smith: georgina.smith2/at/nhs.net; Steven Reid: steve.reid/at/nhs.net; Simon Dupont: Simon.dupont/at/nhs.net; David Murphy: d.j.murphy/at/imperial.ac.uk; Sarah Byford: s.byford/at/kcl.ac.uk; Duolao Wang: duolao.wang/at/lshtm.ac.uk; Barbara Barrett: barbara.m.barrett/at/kcl.ac.uk
Received April 14, 2011; Accepted June 14, 2011.
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.
Method/Design
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.
Discussion
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
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