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Health Anxiety Treatment — MRCPsych Paper B MCQ

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ModerateAnxiety & Stress-Related DisordersHealth Anxiety TreatmentMRCPsych Paper B

A 40-year-old man has persistent health anxiety. Appropriate medical assessment has not identified a physical disorder, but he repeatedly checks his body, seeks reassurance and requests further investigations. His symptoms cause marked functional impairment, and he agrees to a high-intensity psychological intervention. In current UK NHS practice, which treatment is most appropriate?

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Correct answer: A — Individual high-intensity CBT focused on health anxiety

The correct answer is A. NICE identifies high-intensity CBT specifically directed at health anxiety as the relevant standard-care intervention in NHS Talking Therapies. It uses a collaborative cognitive-behavioural formulation to address catastrophic interpretations of bodily sensations and maintaining behaviours such as repeated checking, reassurance seeking, avoidance and requests for unnecessary investigations. Short-term psychodynamic psychotherapy is an alternative considered in some other anxiety disorders, particularly social anxiety when CBT is declined, but is not standard treatment for health anxiety. EMDR is principally indicated for PTSD. CBT with exposure and response prevention is the characteristic treatment for OCD, although behavioural experiments and exposure may form part of health-anxiety CBT. Mindfulness may be used as an adjunct but mindfulness-based therapy alone is not the established high-intensity treatment.

Reference: National Institute for Health and Care Excellence. Digitally enabled therapies for adults with anxiety disorders: early value assessment (HTG676), section 2.3, “Comparator”, 2023. https://www.nice.org.uk/guidance/htg676/chapter/2-The-technology