Clinical StudiesCognitive-behavioral therapy for noncardiac chest pain: a randomized trial
Section snippets
Subjects
Eligible subjects were 1,135 patients who had been referred by their general practitioners to the cardiology clinic of the Leiden University Hospital or the Diaconessenhuis Hospital between 1992 and the first months of 1996 and who had received a discharge diagnosis of noncardiac chest pain. The study was approved by the medical ethics committees of both hospitals. Patients were contacted by mail and asked about the presence, frequency, and severity of noncardiac chest pain, and their interest
Results
Of 1,135 screened patients, 143 were eligible and potentially interested in participating, of whom 72 were enrolled (Table 1). Six patients subsequently dropped out at the beginning of the study, either because they did not want to enter the control group (n = 3) or because they believed the treatment and assignments would be too time consuming (n = 3). One additional patient developed a major depressive episode during treatment and had to be excluded. Two patients (1 in each group) were not
Discussion
Cognitive-behavioral therapy for patients with noncardiac chest pain was effective in comparison with usual care. One-half of the patients in the treatment group were pain free at the end of treatment, compared with approximately one-third of those who were pain free (or had only mild symptoms) in previous randomized trials of cognitive-behavioral therapy for noncardiac chest pain 21, 22. One explanation for why our results are somewhat better might be that our treatment model was based on a
Acknowledgements
We wish to thank Geeraldine Koch, Ella Mutter, and Christien Weenen for their assistance in collecting data.
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