Accuracy of self-referral in health anxiety: comparison of patients self-referring to internet-delivered treatment versus patients clinician-referred to face-to-face treatment

Severe health anxiety is a chronic and costly disorder if untreated. Patient self-referral may lower barriers to treatment and decrease diagnostic delay. This study evaluated the accuracy of self-referral for severe health anxiety and compared characteristics of patients self-referred to internet-de...

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Bibliographic Details
Published in:BJPsych open 2019-09, Vol.5 (5), p.e80, Article e80
Main Authors: Hoffmann, Ditte, Rask, Charlotte Ulrikka, Hedman-Lagerlöf, Erik, Eilenberg, Trine, Frostholm, Lisbeth
Format: Article
Language:English
Subjects:
Accuracy
Adults
Anxiety
barriers to treatment
Cognition & reasoning
Health anxiety
Health care
Health literacy
Health surveys
hypochondriasis
Internet
internet intervention
Medical referrals
Medicin och hälsovetenskap
Patients
Questionnaires
self-referral
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Summary:Severe health anxiety is a chronic and costly disorder if untreated. Patient self-referral may lower barriers to treatment and decrease diagnostic delay. This study evaluated the accuracy of self-referral for severe health anxiety and compared characteristics of patients self-referred to internet-delivered treatment with patients referred by a clinician to face-to-face treatment. Two trials in the same clinic employed different referral methods for health anxiety, namely self-referral and clinician-referral (trial registration: clinicaltrials.gov: NCT01158430 and NCT02735434). The trials were conducted at different time points but with largely comparable eligibility criteria. The accuracy of the recruitment methods was compared by looking at the number of eligible patients in the two trials. Patients completed a baseline questionnaire and subsequently underwent a diagnostic interview by experienced clinicians. Mean differences in self-report and clinical data explored between-group demographic and clinical characteristics. In total, 101/151 (67%) self-referred patients were eligible compared with 126/254 (50%) clinician-referred patients (P = 0.001). Self-referred patients were 3.4 years older (P = 0.008) and had a somewhat higher educational level (P = 0.030). Patients who self-referred reported significantly higher levels of health anxiety, emotional distress and somatic symptoms compared with clinician-referred patients. Yet, they had less clinician-assessed comorbid anxiety disorders (P
ISSN:2056-4724
2056-4724
DOI:10.1192/bjo.2019.54