A brief cognitive-behavioral intervention for patients with noncardiac chest pain

This study assessed whether the addition of a brief (60-minute) CBT intervention delivered in an emergency department improved outcomes for patients seeking services there for noncardiac chest pain. Patients (N = 59) were recruited after their medical evaluation and randomized to CBT intervention (involving psychoeducation, diaphragmatic breathing exercises, and cognitive restructuring about physical symptoms) or treatment-as-usual control. The principal hypothesis that the CBT group would show greater improvement relative to controls was partially supported. The CBT group demonstrated a greater decrease in frequency of chest pain episodes, anxiety sensitivity, and fear of cardiac symptoms at 1- and 3-month follow-up assessments, although there were no differences on chest pain severity, cardiac-related avoidance or attention, quality of life, or general psychological distress.