Long-term consequences of severe health anxiety on sick leave in treated and untreated patients: Analysis alongside a randomised controlled trial

•Patients with HA show significantly more weeks on SB compared to the general population.•A significant within-group decrease in SB was found from baseline to 20 months after therapy.•Decreases in SB were not significantly different when compared with a waitlist group.•A possible beneficial effect of psychotherapy for HA on SB needs further investigation.

Health anxiety (HA) is prevalent and costly for health services. However, little is known about the full societal burden of HA. Based on complete register data, we (1) compared weeks on sickness-related benefits (SB) in untreated patients with severe HA (n = 126) with a matched population sample (n = 12,600); and (2) tested whether Acceptance & Commitment group Therapy (ACT-G) (n = 63) reduced weeks on SB during the first year after randomisation compared to a waitlist (n = 63). We found that (1) HA patients showed a six-monthly increment of 2 weeks on SB compared with the general population (p < 0.0001), and (2) that ACT-G and the waitlist showed no difference in their ability to reduce SB during the first year (p = 0.246). We conclude that HA is associated with a considerable societal burden. A possible beneficial effect of psychotherapy on SB needs further investigation.