Tackling health anxiety could save NHS over £400m a year, study finds

Researchers find people who have had a serious illness fear it will happen again and symptoms persist when nothing is wrong

The NHS could save more than £420m a year by offering treatment for health anxiety and “cyberchondria”, a psychological ailment caused by people obsessively looking up their symptoms online, a study has estimated.

The study, funded and published by the National Institute for Health Research, said the savings could be made just on the costs of care in hospital outpatient departments, with research showing health anxiety fades and stays away after a course of therapy.

A team including researchers from Imperial College London and King’s College London are now calling for health anxiety to be more widely recognised as a condition and for the National Institute for Health and Care Excellence (Nice) to produce guidelines on managing it.

The team estimates that at least one in five people attending hospital outpatient appointments suffers from health anxiety, although only one in 10 are ever diagnosed.

Many have recovered from a serious illness such as a heart attack or cancer and believe it is going to happen again. Symptoms such as chest pain and headaches persist even when doctors tell patients there is nothing wrong. They believe the worst possible scenarios they read online and repeatedly return for tests.

Dr Helen Tyrer, one of the study’s authors, told of the manager of a big company who was driving home when he felt very unwell. He phoned his wife and asked her to call an ambulance, which arrived as he reached his house. “He walked into the kitchen and had a cardiac arrest,” said Tyrer.

His action in calling the ambulance saved his life, she said. After treatment he was well, but so anxious that he could not return to his job. “Every time he got a headache he went to A&E. He didn’t go to work for six months,” she said.

In a trial of cognitive behaviour therapy (CBT) he did “incredibly well” and he was now back at work and leading a normal life.

Another man in the trial had been discharged from hospital after a heart attack and was terrified it would happen again. “He wouldn’t go out of the house to feed his chickens,” said Tyrer. “His wife gave up her job.”

The researchers found him in a hospital waiting room, just discharged after six months as apparently fine. “He clearly wasn’t,” she said.

In the trial, involving 444 patients, even those who were not given therapy but who had health anxiety explained to them got somewhat better, at least in the short term. “By explaining health anxiety, it makes a difference to the symptoms and has an impact on patients’ behaviour,” said Peter Tyrer, a professor of community psychiatry at Imperial, lead author and the husband of Helen Tyrer.

These were not strictly the “worried well”, said the researchers. They had been ill and had genuine symptoms, even if they were sometimes psychosomatic. In the trial they saw a doctor, such as a cardiologist, who would assess the physical symptoms alongside a psychiatrist or psychologist who would assess their anxiety. They might be prescribed breathing or relaxation exercises for their pain, alongside CBT for the anxiety.

Remarkably for a mental health study, the patients given CBT were still doing well five years later. The researchers are calling for Nice to assess the intervention and issue guidelines to the NHS, in the hope that it will be adopted in all hospital trusts.

Yvonne Lisseman Stones, a general nurse at Sherwood Forest Hospitals NHS foundation trust, who worked on the study, said it was the project that had given her the most satisfaction in her 40 years of nursing, “simply because it changes lives”.

She said: “One of my patients had stopped all physical activity because of severe health anxiety, but after therapy was able to climb Mount Snowdon, where he wrote to me and said ‘thank you for making me feel on top of the world’.”


Sarah Boseley Health editor

The GuardianTramp

Related Content

Article image
Surge in teenagers self-poisoning renews mental health concerns
Almost two in three poisonings are intentional – up 50% in past 20 years – with young women most affected, data shows

Sarah Johnson

17, May, 2016 @4:26 PM

Article image
Report finds some NHS mental health trusts screen all patients for radicalisation
Study by Warwick University also found patients referred to Prevent programme for watching Arabic TV or going to Mecca

Diane Taylor

19, Mar, 2018 @9:19 AM

Article image
Ministers under fire over breaking of mental health crisis pledge in England
Target to end ‘inappropriate’ out-of-area placements by April 2021 due to lack of beds has not been met

Denis Campbell Health policy editor

29, Sep, 2021 @9:25 AM

Article image
Mental health goals may not be met, audit office warns
Waiting-time targets were scheduled to start in April, but NAO report says officials do not yet have a grip on how much the policy will cost

Rajeev Syal

20, Apr, 2016 @11:01 PM

Article image
NHS mental health funding is still lagging behind, says report
Only half of mental health trusts have reported increases to budgets since 2012 when ‘parity of esteem’ with physical health was promised

Denis Campbell Health policy editor

09, May, 2016 @5:00 AM

Article image
Ex-Southern Health boss gets £190,000 payoff for quitting advisory role
Katrina Percy, who moved sideways after resigning as chief executive of scandal-hit NHS trust, leaves post after public pressure

Sandra Laville and agency

07, Oct, 2016 @4:52 PM

Article image
The NHS 10-year plan: what we already know
Changes will include a mental health overhaul and advances in diabetes care

Denis Campbell Health policy editor

06, Jan, 2019 @7:27 PM

Article image
New Order singer criticises ‘ludicrous’ NHS mental health waiting lists
People in crisis can’t wait 18 months, says Bernard Sumner at suicide prevention event in parliament

Robert Booth Social affairs correspondent

18, May, 2022 @6:35 PM

Article image
Inquiry investigates deaths of 1,500 NHS mental health patients in Essex
People died in ‘unexpected, unexplained or self-inflicted’ circumstances from 2000 to 2020

Denis Campbell Health policy editor

27, Mar, 2022 @11:01 PM

Article image
Sharp rise in wait times for perinatal mental health care in England
Exclusive: New and expectant mothers left to ‘suffer in silence’ as demand outstrips supply

Peter Walker Deputy political editor

04, Sep, 2023 @5:00 AM