Health anxiety: A narrative review of psychological interventions

Health anxiety is a common condition that can lead to high levels of psychological distress and impaired functioning and, if not properly treated, a worse prognosis. Therefore, providing an organized view of the work done and examining the effectiveness of psychological treatments in this field it can help specialists in choosing the most effective and efficient treatment from the perspective of the conducted research, accelerating the recovery of patients and reducing health costs. Therefore, the present research was conducted with the aim of reviewing the cognitive and metacognitive theories of health anxiety and the treatments resulting from them. The current narrative review in 2023, considering Persian and English keywords, was searched for articles in the time range of 1990 to now, in several famous databases (PubMed, Science direct, Scopus, Google Scholar and SID). By applying the inclusion and exclusion criteria, 38 articles were finally examined. The findings showed that in explaining the pathology of this disorder, there are important cognitive and metacognitive mechanisms and beliefs, each of which can play a role. Following that, studies showed a significant effect size in the relationship between cognitive and metacognitive therapies with health anxiety. The results of this article showed that each of the generalized or specific cognitive beliefs (such as anxiety sensitivity and Salkoskis and Varik's beliefs) and metacognitive beliefs accounted for unique variance in health anxiety scores. As a result, none of the content-based beliefs or metacognitive beliefs could explain the experience of health anxiety alone. Also, although the cognitive behavioral therapy performed on health anxiety showed a great effect, but more than half of the people did not show improvement. As a result, the effectiveness of metacognitive therapy was more encouraging than cognitive behavioral therapy in improving symptoms of health anxiety disorder and distress caused by it.