Cognitive behavioural therapy ineffective for noncardiac chest pain
A brief cognitive behavioural therapy (CBT) intervention neither improves psychological health nor cuts representation of patients with a history of noncardiac chest pain (NCCP), reports a new study.
Researchers randomly assigned patients presenting with chest pain to receive either CBT (n=214) or treatment-as-usual (n=210). The primary outcome was the change in utilization of healthcare resources, measured as representation of patients to the emergency department and NCCP hospitalizations. Psychological health, chest pain, quality of life and social functioning were secondary outcomes.
After 3 months of follow-up, 16.2 percent of the CBT group required repeat presentation to the hospital. This was not significantly different than that in the control group (18.4 percent; p>0.50). This between-group discrepancy continued to be null at the 12-month follow-up (28.5 percent vs 24.0 percent; p>0.30).
CBT likewise yielded no significant improvements in terms of secondary outcomes. Self-report chest pain, for instance, occurred with comparable frequencies between the treatment and control groups at 3 months (37.0 percent vs 35.7 percent; p>0.70) and 12 months (33.3 percent vs 38.0 percent; p>0.30).
The same was true for depression/anxiety (3 months: 4.88 percent vs 5.73 percent; p>0.10; 12 months: 4.20 percent vs 4.67 percent; p>0.30) and mental (3 months: 43.20 percent vs 42.78 percent; p>0.40; 12 months: 42.94 percent vs 42.66 percent; p>0.60) and physical (3 months: 48.83 percent vs 48.57 percent; p>0.50; 12 months: 48.51 percent vs 47.91 percent; p>0.20) quality of life.