Cognitive-behavioral therapy for noncardiac chest pain: a randomized trial

Am J Med. 1999 Apr;106(4):424-9. doi: 10.1016/s0002-9343(99)00049-2.


Purpose: Patients with nonischemic chest pain frequently experience recurrent symptoms, have persistent functional and occupational disability, and are high utilizers of health-care resources. Our aim was to evaluate the efficacy of a cognitive-behavioral treatment for patients with noncardiac chest pain.

Patients and methods: Subjects were recruited from patients with at least weekly episodes of noncardiac chest pain, as diagnosed by a cardiologist. The main outcome measures were frequency and intensity of chest pain at 6 and 12 months.

Results: Seventy-two patients were enrolled in the study; 37 were assigned to cognitive-behavior therapy and 35 to usual care. Sixty-five patients completed the study. Intervention patients improved significantly with regard to frequency and intensity of chest pain: 15 (48%) of the 31 patients in the treatment group were pain free at 12-month follow-up compared with 4 (13%) of the 33 patients in the control group (P = 0.002).

Conclusions: Cognitive-behavioral therapy for noncardiac chest pain patients was effective compared with usual care.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Behavior Therapy*
  • Chest Pain / psychology*
  • Chest Pain / therapy*
  • Cognitive Behavioral Therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Time Factors
  • Treatment Outcome