What are the recommended psychological therapies for managing Illness Anxiety Disorder in primary care?

Recommended psychological therapies for managing Illness Anxiety Disorder in primary care primarily involve cognitive behavioural therapy (CBT) approaches. Although specific NICE guidelines for Illness Anxiety Disorder (hypochondriasis) are limited, the management principles align closely with those for generalized anxiety disorders and health anxiety, where CBT is the mainstay treatment.

In primary care, low-intensity psychological interventions such as individual guided self-help or non-facilitated self-help based on CBT principles are recommended initially. These involve structured written or electronic materials with minimal therapist contact or brief support sessions, typically over 6 weeks or more.

If symptoms persist or there is marked functional impairment, high-intensity individual CBT sessions (usually 12–15 weekly sessions lasting about 1 hour each) are advised. This approach helps address the excessive worry and reassurance-seeking behaviours characteristic of Illness Anxiety Disorder.

Other psychological therapies such as applied relaxation may be considered, but CBT remains the preferred evidence-based option in primary care settings.

Referral to specialist mental health services should be considered if there is inadequate response to these interventions, significant comorbidity, or severe functional impairment.

In summary, the stepped-care model recommends starting with low-intensity CBT-based self-help interventions in primary care, progressing to high-intensity individual CBT if needed, with referral to specialist services for complex cases.

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