HealthNewsReview.org | Independent Expert Reviews of News Stories | Holding Health and Medical Journalism Accountable

Drug may help hypochondriacs

January 08, 2007

Read The Story
RATING:

And now, a real pill for your unreal illness. Scientists report that the antidepressant Paxil helped hypochondriacs be less fearful about getting sick.

Our Review Summary

First, let's emphasize that this is a brief article in a "Science Notebook" section.  It runs only 244 words. There are risks in trying to condense medical research stories into 244 words, and this story reflects those risks.

This is a very incomplete story about a possible treatment option for hypochondriasis. 

The story did not include information on the prevalence of hypochondriasis in the population, and didn't differentiate between cases that might fit the definition of "potentially serious" and others.  Yet it highlighted one study participant (without telling how many were in the trial) "who said he had fears starting at age 10 that he was going to die in his sleep."  Is that a common, representative example?  Or is it an extreme?  

On the other hand, the opening line - "a real pill for your unreal illness"  - insults people who do have this condition.

It lacks information on the benefits or harms of Paxil, and didn't quantify any of the study findings.  The story did not adequately describe the size, design, duration or outcomes of the trial. It makes no comparison with other treatment options available to people who are troubled by this condition.

It is apparently a single-source story; the source of information for this study appears to be a journal article.  No one is quoted. There is no evidence of any input sought from any source independent of the study.  See our primer on the risks of single-source stories.

While it was helpful to mention that the scientists received funds from the manufacturer of the drug discussed, this story did more to promote the use of Paxil for hypochondria than did the actual study. 


 

Click on Criteria for definitions.

The story is about the medication Paxil, which is a readily available prescription medication though the piece failed to mention this and the fact that the use of Paxil in the treatment of hypochondriasis has not been approved by the FDA.

X-mark
Discuss costs? - NOT SATISFACTORY

There was no mention of costs.

X-mark
Avoid "disease-mongering"? - NOT SATISFACTORY

The story did not include information on the prevalence of hypochondriasis in the population, and didn't differentiate between cases that might fit the definition of "potentially serious" and others.  Yet it highlighted one study participant (without telling how many were in the trial) "who said he had fears starting at age 10 that he was going to die in his sleep."  Is that a common, representative example?  Or is it an extreme?  

On the other hand, the opening line - "a real pill for your unreal illness"  - insults people who do have this condition.

The story did not adequately describe the size, design, duration or outcomes of the trial.

Although the story did not explicitly mention that the study was a randomized controlled trial, it did explain that Paxil was compared to a sugar pill (placebo) and to cognitive behavioral therapy for effectiveness in helping people affected by hypochondria.  However, the story did not accurately represent the results of the study.  The story said "the medication significantly reduced people's fears about imaginary illnesses." But, in fact, only when you compared the three groups (Paxil, cognitive behavioral therapy, and sugar pill) did one find that there were significant differences among the groups.  A back of the envelope comparison only between those taking Paxil and placebo finds that the difference between these two is not statistically significant.

X-mark

There was no mention of potential risks with the use of Paxil.

The story suggested that this was a new use for the drug Paxil.

The story contained an anecdote on the improvement one person observed after taking Paxil.  However, there was no quantification of the average benefit, the range of benefit observed, or even an explanation of what benefit was observed.

We can't judge if the story relied solely or largely on a news release.  No one is quoted.  It appears to be drawn directly from an article in the American Journal of Psychiatry and may have been spawned by a news release.  

The source of information for this study appears to be a journal article.  No one is quoted. There is no evidence of any input sought from any source independent of the study.  

The only options one could glean from the story were the use of cognitive behavioral therapy or the drug Paxil for management of hypochondria.  There was no discussion of other medications that are used for this purpose, nor any other psychological approaches that are used.

The story mentioned "a combination of this talk therapy and medication might be especially effective" though the study on which this story was written contained no data on this combination and so this is pure speculation.

Total Score: 1 of 9 Satisfactory

The U.S. Preventive Services Task Force is considered the gold standard of preventive health recommendations - including on screening tests. It's a good source for journalists and consumers.

Read More

About 70% of the stories reviewed from 2006-9 failed to adequately discuss costs, or to explain how big (or small) are the potential benefits and harms of treatments, tests, products and procedures.

Read More

We have documented a disturbing trend of news stories taking an advocacy stance, promoting certain screening tests outside the boundaries of scientific evidence.

Read More

Stories on new technologies like Cyberknife, DaVinci robotic surgery systems, and proton beam cancer therapy often fail to scrutinize the evidence and/or to discuss the costs involved.

Read More

Rather than suggesting that everyone should be screened for everything, news stories could explain: "All screening tests cause harm; some may do good."

Read More

The first 38 network TV network morning health news stories reviewed in 2009 earned an average score of 1.2 stars. 13 of the 38 stories got ZERO stars.

Read More

Both TIME magazine and BusinessWeek have published terrific stories explaining the importance of the Number Needed to Treat - or NNT.

Read More

Knowing relative risk reduction is like knowing you have a 50% off coupon but not knowing whether it's for a Lexus or a lollipop. Absolute risk reduction tells you what the "coupon" is worth. Read more.

Read More

The website NoFreeLunch.org posts "a database of health care professionals who have pledged to accept no gifts from industry and to rely on non-promotional sources of information."

Read More

To help journalists cover stories responsibly, we post a list of independent experts who state that they do not have financial ties to drug or medical device manufacturers.

Read More

We apply the same ten standardized criteria to the review of every story.

Read More

We have about 30 story reviewers. Each story is reviewed by 3 different people.

Read More

Gary Schwitzer's seven words you shouldn't use in medical news: cure, miracle, breakthrough, promising, dramatic, hope, victim. Read why.

Read More

Our reviewers include two former CNN medical reporters and a former editor of the Washington Post health section.

Read More