A controlled trial of cognitive behavioural therapy for non-cardiac chest pain

被引:117
作者
Mayou, RA [1 ]
Bryant, BM [1 ]
Sanders, D [1 ]
Bass, C [1 ]
Klimes, I [1 ]
Forfar, C [1 ]
机构
[1] JOHN RADCLIFFE HOSP,OXFORD OX3 9DU,ENGLAND
关键词
D O I
10.1017/S0033291797005254
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Background. The majority of patients presenting to cardiac clinics with chest pain who are reassured they do not have heart disease or other serious physical disorder continue to experience symptoms, worry about heart disease and restrict their activities. This randomized trial investigated the effectiveness of psychological treatment within routine cardiac care. Methods. Consecutive patients presenting with chest pain and reassured by a cardiologist they do not have heart disease were reassessed 6 weeks later. Those with persistent limiting symptoms were offered the opportunity to participate in a trial of cognitive behavioural therapy. Results. Thirty-seven subjects agreed to take part. A number of subjects were unenthusiastic about psychological intervention or, following explanation of the study, regarded further treatment as not being necessary. At 3 months there were significant differences between the treatment group and the control group on key outcome measures of symptoms, mood and activity. At 6 months there were fewer differences but significant advantages of treatment in terms of limitation of activities and worry about physical symptoms. Conclusion. We conclude that there is a need for 'stepped' further care following reassurance in the cardiac clinic and that cognitive behavioural treatment is effective with those with persistent disabling symptoms.
引用
收藏
页码:1021 / 1031
页数:11
相关论文
共 9 条
[1]  
Bass C, 1995, TREATMENT OF FUNCTIONAL SOMATIC SYMPTOMS, P328
[2]   CHEST PAIN WITH NORMAL CORONARY-ARTERIES - A COMPARATIVE-STUDY OF PSYCHIATRIC AND SOCIAL MORBIDITY [J].
BASS, C ;
WADE, C .
PSYCHOLOGICAL MEDICINE, 1984, 14 (01) :51-61
[3]   THE BRIEF SYMPTOM INVENTORY - AN INTRODUCTORY REPORT [J].
DEROGATIS, LR ;
MELISARATOS, N .
PSYCHOLOGICAL MEDICINE, 1983, 13 (03) :595-605
[4]  
Guthrie E, 1995, TREATMENT OF FUNCTIONAL SOMATIC SYMPTOMS, P144
[5]   PSYCHOLOGICAL TREATMENT FOR ATYPICAL NONCARDIAC CHEST PAIN - A CONTROLLED EVALUATION [J].
KLIMES, I ;
MAYOU, RA ;
PEARCE, MJ ;
COLES, L ;
FAGG, JR .
PSYCHOLOGICAL MEDICINE, 1990, 20 (03) :605-611
[6]  
MAYOU R, 1994, BRIT HEART J, V72, P548
[7]   DIMENSIONS OF HYPOCHONDRIASIS [J].
PILOWSKY, I .
BRITISH JOURNAL OF PSYCHIATRY, 1967, 113 (494) :89-&
[8]   Non-cardiac chest pain: why was a brief intervention apparently ineffective? [J].
Sanders, D ;
Bass, C ;
Mayou, RA ;
Goodwin, S ;
Bryant, BM ;
Tyndel, S .
PSYCHOLOGICAL MEDICINE, 1997, 27 (05) :1033-1040
[9]  
Spitzer R.L., 1986, Structured Clinical Interview for DSM-III-R- Patient Version