Effectiveness of the unified protocol for treating co-morbid health anxiety and depression: an empirical case study

Aims: The unified protocol (UP) is indicated when patients present with co-morbidity, but no studies have previously investigated the effectiveness of the UP with co-morbid health anxiety and depression.

Method: An A/B single case design evaluated outcomes for a 27-year-old male presenting with health anxiety and co-morbid depression. Following a 21-day assessment-baseline period containing three sessions, the manualised UP was delivered across a 42-day period containing seven intervention sessions. Four idiographic measures (occurrence and duration of health checking, sleep duration and food intake satisfaction) were collected daily throughout, and two nomothetic measures were collected at four time points.

Results: All sessions were attended. Number of health checking episodes reduced from four per day to two per day. A 59 minute per day reduction in time spent health checking occurred, and sleep increased by 100 minutes per night. There was little apparent change in terms of food intake satisfaction. There was a reliable and clinically significant reduction in depression.

Discussion: Further testing of the effectiveness of the UP with co-morbid health anxiety and depression in true single case experimental designs is now indicated.