Hostname: page-component-848d4c4894-xm8r8 Total loading time: 0 Render date: 2024-06-28T15:18:35.407Z Has data issue: false hasContentIssue false
  • English
  • Français

Cognitive Behavioural Therapy for Unexplained Non-Cardiac Chest Pain: A Pilot Study

Published online by Cambridge University Press:  16 June 2009

Anke S. Van Peski-Oosterbaan ,
Philip Spinhoven ,
Yanda van Rood ,
A. J. Willem Van der Does  and
Albert J. V. Bruschke
Anke S. Van Peski-Oosterbaan
Affiliation:
Leiden University Medical Center, The Netherlands
Philip Spinhoven
Affiliation:
Leiden University Medical Center, The Netherlands
Yanda van Rood
Affiliation:
Leiden University Medical Center, The Netherlands
A. J. Willem Van der Does
Affiliation:
Leiden University Medical Center, The Netherlands
Albert J. V. Bruschke
Affiliation:
Leiden University Medical Center, The Netherlands
Get access Rights & Permissions [Opens in a new window]

Abstract

The aim of this study was to develop and evaluate the feasibility of a cognitive behavioural treatment for unexplained chest pain (UCP), based on the cognitive model of UCP. Ten patients were treated. The diagnosis had been made by a cardiologist two years before the start of treatment. The treatment incorporated breathing and relaxation training, identifying and challenging beliefs about the cause of UCP, behavioural experiments and problem solving for social problems. Patients improved significantly with regard to intensity and duration of chest pain, anxiety and functional limitations. Moreover, the reduction of scores for fear of bodily sensations and of credibility ratings of idiosyncratic disease related negative automatic thoughts was significant. The changes in scores for the inclination to interpret bodily sensations catastrophically almost reached the level of significance. These results suggests that therapy results may be cognitively mediated.

Type
Clinical Section
Information
Behavioural and Cognitive Psychotherapy , Volume 25 , Issue 4 , October 1997 , pp. 339 - 350
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders. Washington DC: APA.Google Scholar
Arrindell, W. A. (1993). The fear of fear concept: Stability, retest artefact and predictive power. Behaviour Research and Therapy, 31, 139–148.CrossRefGoogle ScholarPubMed
Barlow, D. H. (1988). Anxiety and its disorders. New York: Guilford Press.Google Scholar
Barsky, A. J. & Klerman, G. L. (1983). Overview: Hypochondriasis, bodily complaints and somatic styles. American Journal of Psychiatry, 140, 273–283.Google ScholarPubMed
Bass, C. & Mayou, R. A. (1995). Chest pain and palpitations. In Mayou, R. A., Bass, C., & Sharpe, M. (Eds.), Treatment of functional somatic symptoms, (pp. 328–352). Oxford: Oxford University Press.Google Scholar
Bass, C. & Wade, C. (1984). Chest pain with normal coronary arteries: A comparative study of psychiatric and social morbidity. Psychological Medicine, 14, 51–61.Google Scholar
Bass, C. M., Wade, C., Hand, D., & Jackson, G. (1983). Patients with angina with normal and near normal coronary arteries: Clinical and psychosocial state 12 months after angiography. British Medical Journal, 287, 1505–1508.CrossRefGoogle ScholarPubMed
Beitman, B. D., Mukerji, V., Flaker, G., & Basha, I. M. (1988). Panic disorder, cardiology patients and atypical chest pain. Psychiatric Clinics of North America, 11, 387–397.Google Scholar
Brazier, J. E., Harper, R., Jones, N. M. B., Cathain, A., Thomas, K. J., Usherwood, T., & Westlake, L. (1992). Validating the SF – 36 health survey questionnaire: Outcome measure for primary care. British Medical Journal, 305, 160–164.CrossRefGoogle ScholarPubMed
Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, E. (1984). Assessment of fear in agoraphobics: The body sensations questionnaire and the agoraphobic cognitions questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090–1097.CrossRefGoogle ScholarPubMed
Chignon, J. M., Lepine, J. P., & Ades, J. (1993). Panic disorder in cardiac outpatients. American Journal of Psychiatry, 150, 780–785.Google Scholar
Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461–470.Google Scholar
Cormier, L. E., Katon, W., Russo, J., Hollifield, M., Hall, M. L., & Vitaliano, P. P. (1988). Chest pain with negative cardiac diagnostic studies. Relationship to psychiatric illness. Journal of Nervous and Mental Disease, 176, 351–358.Google Scholar
Cox, B. J. (1996). The nature and assessment of catastrophic thoughts in panic disorder, invited essay. Behaviour Research and Therapy, 34, 363–374.CrossRefGoogle Scholar
Engel, B. T., Baille, W. F., Coasta, P. T., Brimlow, D. L., & Brinker, J. (1985). A behavioural analysis of chest pain in patients suspected of having coronary artery disease. Psychosomatic Medicine, 47, 274–284.Google Scholar
Fleet, R. P., Dupuis, G., Marchand, A., Burelle, D., & Beitman, B. D. (1994). Panic disorder, chest pain and coronary artery disease: Literature review. Canadian Journal of Cardiology, 10, 827–834.Google ScholarPubMed
Hegel, M. T., Abel, G. G., Etscheidt, M., Cohen-Cole, S., & Wilmer, C. (1989). Behavioral treatment of angina-like chest pain in patients with hyperventilation syndrome. Journal of Behaviour Therapy and Experimental Psychiatry, 20, 31–39.CrossRefGoogle ScholarPubMed
Holroyd, K. A., Penzien, D. B., Hursey, K. G., Tobin, D. L., Rogers, L., Holm, J. E., & Marcille, P. J. (1984). Change mechanisms in EMG biofeedback training: Cognitive changes underlying improvements in tension headaches. Journal of Consulting and Clinical Psychology, 52, 1039–1053.Google Scholar
Katon, W., Hall, M. L., Russo, J., Cormier, L., Hollifield, M., Vitaliano, P. P., & Beitman, B. D. (1988). Chest pain: Relationship of psychiatric illness to coronary arteriographic results. American Journal of Medicine, 84, 1–9.Google Scholar
Katz, P. O., Dalton, C. B., Richter, J. E., Wu, W. C., & Castell, D. O. (1987). Esophageal testing of patients with noncardiac chest pain or dysphagia. Annals of Internal Medicine, 106, 593–597.CrossRefGoogle ScholarPubMed
Kellner, R. (1987). Hypochondriasis and somatization. Journal of the American Medical Association, 258, 2718–2722.Google Scholar
Klimes, I., Mayou, R. A., Pearce, M. J., Coles, L., & Fagg, J. R. (1990). Psychological treatment for atypical non-cardiac chest pain: A controlled evaluation. Psychological Medicine, 20, 605–611.Google Scholar
Mayou, R. (1989). Invited review: Atypical chest pain. Journal of Psychosomatic Research, 33, 393–406.Google Scholar
Mayou, R. A., Bryant, B., Forfar, C., & Clark, D. M. (1994). Non-cardiac chest pain and benign palpitations in the cardiac clinic. British Heart Journal, 72, 548–553.Google Scholar
McNally, R. J., Riemann, B. C., & Kimm, E. (1990). Selective processing of threat cues in panic disorder. Behaviour Research and Therapy, 28, 407–412.Google Scholar
Pearce, M. J., Mayou, R. A., & Klimes, I. (1990). The management of atypical non-cardiac chest pain. Quarterly Journal of Medicine, 76, 991–996.Google ScholarPubMed
Proudfit, W. L., Bruschke, A. V., & Sones, F. M. J. (1980). Clinical course of patients with normal coronary arteriography: Follow-up study of 121 patients with normal or slightly or moderately abnormal coronary arteriograms: 10 year follow-up of 521 patients. Circulation, 62, 712–717.Google Scholar
Rapoport, E. (1986). Angina and oesophageal pain. European Heart Journal, 7, 827.Google Scholar
Ruiter, C. D., Bouman, T. K., & Hoogduin, C. A. L. (1993) Anxiety Disorders Interview Schedule, Dutch version. Utrecht: Internal publication, University of Utrecht.Google Scholar
Salkovskis, P. M. (1989). Somatic problems. In Hawton, H., Salkovskis, P. M., Kirk, J. & Clark, D. M. (Eds.), Cognitive behaviour therapy for psychiatric problems: A practical guide. Oxford: Oxford University Press.Google Scholar
Salkovskis, P. M. (1992). Psychological treatment of noncardiac chest pain: The cognitive approach. American Journal of Medicine, 92 (suppl 5A), 114–121.Google Scholar
Speckens, A. E. M., Van Hemert, A. M., Spinhoven, P., Hawton, K. E., Bolk, J. H., & Rooijmans, H. G. M. (1995). Cognitive behavioural therapy for medically unexplained physical symptoms: A randomised controlled trial. British Medical Journal, 311, 1328–1332.Google Scholar
Spinhoven, P., Ormel, J., Sloekers, P. P. A., Kempen, G. I. J. M., Speckens, A. E. M., & Van Hemert, A. M. (1997). A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychological Medicine, 27, 363–370.Google Scholar
Tew, R., Guthrie, E. A., Creed, F. H., Cotter, L., Kisely, S., & Tomenson, B. (1995). A long-term follow-up study of patients with ischaemic heart disease versus patients with nonspecific chest pain. Journal of Psychosomatic Research, 39 (5), 977–985.CrossRefGoogle ScholarPubMed
Van Der Zee, K. I. & Sanderman, R. (1993). Het meten van de algemene gezondheidstoestand met de RAND-36. Een handleiding. Groningen: University of Groningen.Google Scholar
Warwick, H. C. & Salkovskis, P. M. (1990). Hypochondriasis. Behaviour Research and Therapy, 28, 105–117.Google Scholar
Zigmund, A. S. & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.Google Scholar
Submit a response

Comments

No Comments have been published for this article.