A complex interplay: cognitive behavioural therapy for severe health anxiety in Addison’s Disease to reduce emergency department admissions

Research output: Contribution to journalArticle

5 Citations (Scopus)
33 Downloads (Pure)

Abstract

Objectives: Addison's Disease is a rare chronic illness caused by adrenocortical insufficiency, commonly treated with synthetic hormones. Due to the pivotal role of the regulating hormone cortisol in Addison’s Disease, there is a common symptom overlap between the presentation of anxiety and adrenal crisis. Previous literature has identified the prevalence of anxiety and depression in endocrinological disorders, however there is a paucity of research examining the complex interplay between Addison’s Disease and anxiety. This paper describes a single case treatment of a patient with severe health anxiety and co-morbid Addison’s Disease who frequently attended and were admitted to the Emergency Department. The aims of the study were to establish if standard cognitive behavioural therapy for health anxiety in Addison’s Disease can lead to a reduction in psychological distress, and whether this approach is an effective intervention for the reduction of Emergency Department admissions.
Method: A single case design was used, with pre and post measures of health anxiety, general anxiety and depression. Data on Emergency Department admissions prior to and following treatment were used to assess change in this domain.

Results: Reliable and clinically significant reductions were seen across all measures, from severe to sub-clinical levels. There was a complete amelioration of Emergency Department admissions in the 12 months following completion of treatment.

Conclusions: This preliminary study provides a sound rationale for further research into Addison’s Disease complicated by anxiety. Findings support the clinical utility of the cognitive behavioural therapy model for complex presentations of Addison’s Disease, offering a potential treatment option where anxiety is elevated and interfering with self-management and leading to high levels of health service use.
Original languageEnglish
Pages (from-to)419-426
JournalBehavioural and Cognitive Psychotherapy
Volume45
Issue number4
Early online date9 Apr 2017
DOIs
Publication statusPublished - Jul 2017

Fingerprint

Addison Disease
Cognitive Therapy
Hospital Emergency Service
Anxiety
Health
Hormones
Depression
Therapeutics
Self Care
Research
Health Status
Health Services
Hydrocortisone
Chronic Disease
Psychology

Cite this

@article{055908fef946412b8196543b755348c6,
title = "A complex interplay: cognitive behavioural therapy for severe health anxiety in Addison’s Disease to reduce emergency department admissions",
abstract = "Objectives: Addison's Disease is a rare chronic illness caused by adrenocortical insufficiency, commonly treated with synthetic hormones. Due to the pivotal role of the regulating hormone cortisol in Addison’s Disease, there is a common symptom overlap between the presentation of anxiety and adrenal crisis. Previous literature has identified the prevalence of anxiety and depression in endocrinological disorders, however there is a paucity of research examining the complex interplay between Addison’s Disease and anxiety. This paper describes a single case treatment of a patient with severe health anxiety and co-morbid Addison’s Disease who frequently attended and were admitted to the Emergency Department. The aims of the study were to establish if standard cognitive behavioural therapy for health anxiety in Addison’s Disease can lead to a reduction in psychological distress, and whether this approach is an effective intervention for the reduction of Emergency Department admissions. Method: A single case design was used, with pre and post measures of health anxiety, general anxiety and depression. Data on Emergency Department admissions prior to and following treatment were used to assess change in this domain. Results: Reliable and clinically significant reductions were seen across all measures, from severe to sub-clinical levels. There was a complete amelioration of Emergency Department admissions in the 12 months following completion of treatment.Conclusions: This preliminary study provides a sound rationale for further research into Addison’s Disease complicated by anxiety. Findings support the clinical utility of the cognitive behavioural therapy model for complex presentations of Addison’s Disease, offering a potential treatment option where anxiety is elevated and interfering with self-management and leading to high levels of health service use.",
author = "Jo Daniels and Elizabeth Sheils",
year = "2017",
month = "7",
doi = "10.1017/S1352465817000182",
language = "English",
volume = "45",
pages = "419--426",
journal = "Behavioural and Cognitive Psychotherapy",
issn = "1352-4658",
publisher = "Cambridge University Press",
number = "4",

}

TY - JOUR

T1 - A complex interplay

T2 - cognitive behavioural therapy for severe health anxiety in Addison’s Disease to reduce emergency department admissions

AU - Daniels, Jo

AU - Sheils, Elizabeth

PY - 2017/7

Y1 - 2017/7

N2 - Objectives: Addison's Disease is a rare chronic illness caused by adrenocortical insufficiency, commonly treated with synthetic hormones. Due to the pivotal role of the regulating hormone cortisol in Addison’s Disease, there is a common symptom overlap between the presentation of anxiety and adrenal crisis. Previous literature has identified the prevalence of anxiety and depression in endocrinological disorders, however there is a paucity of research examining the complex interplay between Addison’s Disease and anxiety. This paper describes a single case treatment of a patient with severe health anxiety and co-morbid Addison’s Disease who frequently attended and were admitted to the Emergency Department. The aims of the study were to establish if standard cognitive behavioural therapy for health anxiety in Addison’s Disease can lead to a reduction in psychological distress, and whether this approach is an effective intervention for the reduction of Emergency Department admissions. Method: A single case design was used, with pre and post measures of health anxiety, general anxiety and depression. Data on Emergency Department admissions prior to and following treatment were used to assess change in this domain. Results: Reliable and clinically significant reductions were seen across all measures, from severe to sub-clinical levels. There was a complete amelioration of Emergency Department admissions in the 12 months following completion of treatment.Conclusions: This preliminary study provides a sound rationale for further research into Addison’s Disease complicated by anxiety. Findings support the clinical utility of the cognitive behavioural therapy model for complex presentations of Addison’s Disease, offering a potential treatment option where anxiety is elevated and interfering with self-management and leading to high levels of health service use.

AB - Objectives: Addison's Disease is a rare chronic illness caused by adrenocortical insufficiency, commonly treated with synthetic hormones. Due to the pivotal role of the regulating hormone cortisol in Addison’s Disease, there is a common symptom overlap between the presentation of anxiety and adrenal crisis. Previous literature has identified the prevalence of anxiety and depression in endocrinological disorders, however there is a paucity of research examining the complex interplay between Addison’s Disease and anxiety. This paper describes a single case treatment of a patient with severe health anxiety and co-morbid Addison’s Disease who frequently attended and were admitted to the Emergency Department. The aims of the study were to establish if standard cognitive behavioural therapy for health anxiety in Addison’s Disease can lead to a reduction in psychological distress, and whether this approach is an effective intervention for the reduction of Emergency Department admissions. Method: A single case design was used, with pre and post measures of health anxiety, general anxiety and depression. Data on Emergency Department admissions prior to and following treatment were used to assess change in this domain. Results: Reliable and clinically significant reductions were seen across all measures, from severe to sub-clinical levels. There was a complete amelioration of Emergency Department admissions in the 12 months following completion of treatment.Conclusions: This preliminary study provides a sound rationale for further research into Addison’s Disease complicated by anxiety. Findings support the clinical utility of the cognitive behavioural therapy model for complex presentations of Addison’s Disease, offering a potential treatment option where anxiety is elevated and interfering with self-management and leading to high levels of health service use.

UR - https://doi.org/10.1017/S1352465817000182

U2 - 10.1017/S1352465817000182

DO - 10.1017/S1352465817000182

M3 - Article

VL - 45

SP - 419

EP - 426

JO - Behavioural and Cognitive Psychotherapy

JF - Behavioural and Cognitive Psychotherapy

SN - 1352-4658

IS - 4

ER -