Cyberchondria May Be Improved With Online CBT

overwhelmed woman
overwhelmed woman
Online searches can reinforce patients’ assumptions about their health status, as well as cause debilitating anxieties.

Internet-based cognitive behavioral therapy (iCBT) may be an effective treatment for patients with cyberchondria, according to an article published in the Journal of Anxiety Disorders. In cyberchondria, patients develop health anxiety from excessive internet searches about illness, which often expose them to misleading, alarming information. Online searches can reinforce patients’ assumptions about their health status, as well as cause debilitating anxieties.

The study included secondary data from patients with a diagnosis of illness anxiety disorder and/or somatic symptom disorder who were randomly assigned to either an iCBT (n=45) or control group (n=41). Over 12 weeks, patients in the iCBT group received 6 lessons of an online anxiety psychoeducation program designed to teach CBT skills, including detecting and challenging negative thinking patterns about bodily symptoms and health. After 2 lessons, they received clinical support via email and/or phone and patients could contact their clinician after subsequent lessons if they reported increased distress or suicidal ideation. Patients in the control group received online fact sheets every 2 weeks on topics related to anxiety and were offered clinician support via email or phone.

Investigators used self-report questionnaires to assess health anxiety and cyberchondria at baseline and post-treatment in both groups and at 3-month follow-up in the iCBT group. The primary outcome was health anxiety as measured by the Short Health Anxiety Inventory (SHAI), whereas cyberchondria was measured with the Cyberchondria Severity Scale (CSS).

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Compared with the control group, patients receiving iCBT showed a significantly greater post-treatment reduction in cyberchondria (CSS total scale: Hedge’s g, 1.09; F[1,67], 22.64; P <.001) and health anxiety (SHAI: Hedge’s g, 1.36; F[1,67], 29.88; P <.001). This improvement was also demonstrated on the compulsion, distress, and excessiveness subscales of the CSS (Hedge’s g range: 0.8–1.13; all P <.001). In mediation analyses, significant decreases in health anxiety in the iCBT group (B, −11.44; t, −6.14; SE, 1.86; P <.001) were mediated by improvements in all CSS subscales except mistrust.

Currently, there are no validated clinical interviews to assess cyberchondria, and all data in this study were collected online via self-report measures, potentially limiting the scope of the findings. Patients in the study were motivated, treatment-seeking, and generally well-educated, suggesting that results might not be generalizable to other populations.

The investigators noted that this study was the first to demonstrate that “clinician-guided internet CBT reduces cyberchondria” in patients with illness anxiety disorder and somatic symptom disorder. They noted that “these results suggest that iCBT may help health anxious individuals to reduce the excessive nature of online health information searches, the distress caused, and reduce the impact of online searching on daily activities.”


Newby JM, McElroy E. The impact of internet-delivered cognitive behavioural therapy for health anxiety on cyberchondria. J Anxiety Disord. 2020;69:102150.