Audio-guided self-hypnosis for reduction of claustrophobia during MR imaging: results of an observational 2-group study

Abstract

Objectives: To evaluate the influence of audio-guided self-hypnosis on claustrophobia in a high-risk cohort undergoing magnetic resonance (MR) imaging.

Methods: In this prospective observational 2-group study, 55 patients (69% female, mean age 53.6 ± 13.9) used self-hypnosis directly before imaging. Claustrophobia included premature termination, sedation, and coping actions. The claustrophobia questionnaire (CLQ) was completed before self-hypnosis and after MR imaging. Results were compared to a control cohort of 89 patients examined on the same open MR scanner using logistic regression for multivariate analysis. Furthermore, patients were asked about their preferences for future imaging.

Results: There was significantly fewer claustrophobia in the self-hypnosis group (16%; 9/55), compared with the control group (43%; 38/89; odds ratio .14; p = .001). Self-hypnosis patients also needed less sedation (2% vs 16%; 1/55 vs 14/89; odds ratio .1; p = .008) and non-sedation coping actions (13% vs 28%; 7/55 vs 25/89; odds ratio .3; p = .02). Self-hypnosis did not influence the CLQ results measured before and after MR imaging (p = .79). Self-hypnosis reduced the frequency of claustrophobia in the subgroup of patients above an established CLQ cut-off of .33 from 47% (37/78) to 18% (9/49; p = .002). In the subgroup below the CLQ cut-off of 0.33, there were no significant differences (0% vs 9%, 0/6 vs 1/11; p = 1.0). Most patients (67%; 35/52) preferred self-hypnosis for future MR examinations.

Conclusions: Self-hypnosis reduced claustrophobia in high-risk patients undergoing imaging in an open MR scanner and might reduce the need for sedation and non-sedation coping actions.

Key points: • Forty percent of the patients at high risk for claustrophobia may also experience a claustrophobic event in an open MR scanner. • Self-hypnosis while listening to an audio in the waiting room before the examination may reduce claustrophobic events in over 50% of patients with high risk for claustrophobia. • Self-hypnosis may also reduce the need for sedation and other time-consuming non-sedation coping actions and is preferred by high-risk patients for future examinations.

Keywords: Anxiety; Hypnosis; Magnetic resonance imaging; Phobic disorders.

Fig. 1

Flow chart of study inclusion in the non-hypnosis and the self-hypnosis cohorts. The cohort without self-hypnosis is a retrospectively evaluated patient population examined on the same MR scanner. In both cohorts, only the first examination was included. A total of 124 (25%) of 494 referred patients were excluded because they did not undergo an examination for different reasons or were scheduled twice. In the control cohort, a majority of patients were excluded due to invasive procedures or general poor health. In the self-hypnosis cohort, 10 (12%) of 87 patients were excluded because they refused to participate. Overall, 144 (29%) of 494 patients were included in the analysis. Given is the number of all noted claustrophobic events. *Further analysis only includes the most severe event per patient

Fig. 2

Frequency of claustrophobia (percentage of patients) in intervention and control groups. Overall, there were fewer claustrophobic events, non-sedation and sedation coping actions, and premature terminations in the self-hypnosis group compared to the control group