Factors associated with pain level in non-cardiac chest pain patients with comorbid panic disorder
نویسندگان
چکیده
BACKGROUND Panic disorder (PD) is highly prevalent in patients with non-cardiac chest pain (NCCP). This study aims to explore the role of psychological factors (PD intensity, anxiety sensitivity, heart-related fear, attention and avoidance) common to NCCP and PD in predicting chest pain levels in patients with both conditions. METHODS This association was investigated in emergency department patients with NCCP and PD receiving either evidence-based treatment of PD or treatment as usual. Patients were assessed at baseline and 14 weeks later for post-treatment. RESULTS Only heart-focused fear and attention for cardiac sensations independently explained a significant portion of the variance in baseline pain (n = 66). At 3 months follow-up (n = 53), changes in heart-related fear was the only factor independently associated with changes in chest pain intensity. Even in patients with PD, fear specific to cardiac sensations seems to play a central role in determining NCCP intensity. CONCLUSION These results suggest that the efficacy of intervention for patients with PD and comorbid NCCP could be improved by targeting heart-related fear and attention. TRIAL REGISTRATION NCT00736346.
منابع مشابه
Cognitive change following cognitive behavioural therapy for non-cardiac chest pain.
BACKGROUND Seventeen to 43% of patients with non-cardiac chest pain suffer from anxiety/panic disorders. Cognitive behavioural therapy (CBT) is effective in reducing non-cardiac chest pain. However, no data are available indicating that pain reduction following CBT may be cognitively mediated or whether success of CBT is dependent on the presence of panic. The aim of the study was threefold: (1...
متن کاملNon-cardiac, non-oesophageal chest pain: the relevance of psychological factors.
BACKGROUND No cause has been determined for chest pain that is neither cardiac nor oesophageal in origin. AIMS To compare the prevalence of life-time psychiatric disorders and current psychological distress in three consecutive series of patients with chronic chest or abdominal pain. PATIENTS Thirty nine patients with non-cardiac chest pain and no abnormality on oesophagogastroduodenoscopy,...
متن کاملPanic Attack with Vergence Therapy an Unexpected Visual-vagus Connection
Panic attacks are a fact of life in today’s culture. As much as 10% of the healthy population can suffer a panic attack within a given year. Various methods of treatment have been described in the literature to counteract these panic attacks. It has been noted that it is possible to alleviate panic disorder anxiety by performing convergence therapy. This somatic intervention functions as a vaga...
متن کاملThe association between panic disorder and coronary artery disease among primary care patients presenting with chest pain: an updated literature review.
CONTEXT Although panic disorder is linked to hypertension and smoking, the relationship between panic disorder and coronary artery disease (CAD) is unclear. OBJECTIVE To extend our understanding about the strength of the association between panic disorder and coronary artery disease and known cardiovascular risk factors. DATA SOURCES Potential studies were identified via a computerized sear...
متن کاملHow Effective Is the Use of Metaphor Therapy on Reducing Psychological Symptoms and Pain Discomfort in Patients with Non-Cardiac Chest Pain: A Randomized, Controlled Trial
Introduction: Psychological symptoms of non-cardiac chest pain (NCCP) including perceptual, emotional, and behavioral problems can effect patient perception of chest pain. This study was conducted to determine the effect of metaphor therapy on mitigating depression, anxiety, stress, and pain discomfort in patients with NCCP. Materials and Methods: This randomized, controlled, trial was conducte...
متن کامل