Hypochondriacal disorder involves persistent anxiety about suffering from an undetected serious medical condition, despite medical reassurance. Hypochondriacal disorder significantly affects social relationships, occupational functioning and personal well-being. In university settings, where mental health concerns are prevalent, insights into prevalence of hypochondriacal disorder and associations with depression and other health challenges are essential.

This study examines the prevalence and correlates of hypochondriacal disorder among Norwegian university students, focusing on its associations with depression, mental distress and somatic symptom burden.

The 2022 Students’ Health and Wellbeing Study, a national survey of Norwegian higher education students, included 59 536 participants aged 18–35. Participants were categorised based on a pre-defined diagnostic list of mental and somatic concerns, and participants were grouped as follows: hypochondriacal disorder only, depression only, comorbid hypochondriacal disorder and depression and controls. Validated instruments included the Somatic Symptom Scale-8, the Hopkins Symptoms Checklist, the Satisfaction With Life Scale, an abbreviated version of the University of California, Los Angeles, Three-Item Loneliness Scale and four items on suicidal ideation.

Hypochondriacal disorder was reported by 0.86% (n = 457) of participants, with 52% also reporting depression. Those with hypochondriacal disorder had significantly worse mental and somatic health outcomes, especially when comorbid with depression, including elevated distress, suicidality, insomnia and poor quality of life.

Although uncommon, hypochondriacal disorder is linked to severe mental and somatic health burdens, particularly when co-occurring with depression. These findings highlight the need for integrated mental health strategies in academic settings to address hypochondriacal disorder and its frequent comorbidities.

Cognitive–behavioural therapy (CBT) is an effective treatment for Hypochondriacal Disorder, but the long-term effect has not been examined extensively.

To investigate the long-term effect of CBT on Hypochondriacal Disorder using several mental health measures. Follow-up time was at least 10 years.

A total of 50 patients with a long history of Hypochondriacal Disorder, diagnosed according to ICD-10, received 16 sessions of individual CBT and were followed up with an uncontrolled design. All participants were assessed before and after the intervention period, and 10 years later. Intention-to-treat mixed-model repeated-measures analysis were conducted. The study has been registered at clinicaltrials.gov: NCT00959452.

Patients displayed significant improvements across all outcomes, including level of health anxiety, somatisation, symptoms of anxiety and depression, quality of life, somatisation at treatment completion. Treatment gains were well maintained 10 years later.

This uncontrolled treatment study suggests that patients treated with CBT for Hypochondriacal Disorder have significantly reduced health anxiety 1 year after treatment completion and the results are maintained 10 years later. The results indicate that CBT has a lasting effect, but the lack of a control group and use of only one therapist, means that care should be taken when generalising the findings.