May cause hypochondriac pain

Treatment of hypochondriasis with CBT and / or SSRI

Inclusion criteria

- Meets DSM-IV criteria for hypochondriasis; determined by structured diagnosis for the hypochondriac module of SCID-I and meets a hypochondrial severity grade of at least "moderate".

- Drug-free of all psychoactive or investigational drugs for 6 weeks (seven weeks for fluoxetine).

- Approval by the attending physician, if psychoactive medication is required at the same time, withdrawn before participation in the course

- Knowledge of English and literacy.

Exclusion criteria

- Pregnant or nursing mothers and women of childbearing potential who do not take adequate contraceptive precautions.

- One of the following axis I mental disorders: chronic pain syndrome, schizophrenia, schizoaffective disorder, delusional disorder, bipolar disorder, alcohol abuse or addiction disorder (current or within the last six months) or substance abuse or addiction disorder (current or within the last twelve months). Patients with other comorbid psychiatric disorders are eligible based on the following three criteria: hypochondriasis must be the predominant presenting disorder; Patient cannot have a severe comorbid psychiatric disorder classified as "severe" in the Clinical Global Impressions scale (CGI scale); and patients cannot have a comorbid psychiatric disorder that causes significant dysfunction (significant function Impairment is defined as impairment that significantly affects expected role function, professional and / or interpersonal).

- Suicide within the last 6 months as determined by a score of 9 or more on the suicide module of the MINI Plus.

- Symptom-related litigation, disability benefits or employee compensation procedures

- Serious medical conditions that are expected to worsen significantly, result in hospitalization, or likely fatal in the next six months, as established using the Cumulative Disease Rating Scale (CIRS); A stable chronic illness is not an exclusion criterion

- Not being able to turn off concomitant psychoactive medications or are currently taking other necessary medications that may adversely affect fluoxetine:

- Clinically important abnormalities on EKG, laboratory tests (including thyroid function) or physical exam. "Clinically important" abnormalities are those that mean that treatment is required or that there is no medical abnormality adequately addressed. Patients with stable and chronic medical problems are eligible, but patients with medical problems that are unstable, acute, or inadequate are excluded. An up-to-date electrocardiogram is required for all patients with symptoms suggestive of heart disease, including chest pain, shortness of breath, palpitations, or drowsiness; If a current electrocardiogram is not available, the study will be conducted and one obtained.

- A history of serious adverse reactions related to fluoxetine or non-compliance with previous CBT for hypochondriasis

- Previous adequate trial with fluoxetine (eight weeks, of which two weeks at a minimum dose of 60 mg / day) or CBT for hypochondriasis (at least four sessions) specifically aimed at hypochondriac symptoms) will be excluded regardless of the previous answer. Inability to have outpatient or mobility impairments that prohibit frequent travel to hospital for treatment and evaluation.