Journal of Psychosomatic Research
Volume 69, Issue 3 , Pages 227-235 , September 2010

Heart-focused anxiety as a mediating variable in the treatment of noncardiac chest pain by cognitive-behavioral therapy and paroxetine

  • Philip Spinhoven

      Affiliations

    • Institute of Psychology, Leiden University, Leiden, The Netherlands
    • Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
    • Corresponding Author InformationCorresponding author. Leiden University, Institute of Psychology, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands. Tel.: +31 71 527 3377; fax: +31 71 527 4678.
    • Shared first authorship.
    • ,
  • A.J. Willem Van der Does

      Affiliations

    • Institute of Psychology, Leiden University, Leiden, The Netherlands
    • Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
    • Shared first authorship.
    • ,
  • Eduard Van Dijk

      Affiliations

    • Institute of Psychology, Leiden University, Leiden, The Netherlands
    • ,
  • Yanda R. Van Rood

      Affiliations

    • Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands

Received 10 October 2009 ,Revised 9 February 2010 ,Accepted 9 February 2010.

References 

  1. Mayou R. Chest pain, palpitations and panic. J Psychosom Res. 1998;44:53–70
  2. Cormier LE, Katon W, Russo J, Hollifield M, Hall ML, Vitaliano P. Chest pain with negative cardiac diagnostic studies: relationship to diagnostic illness. J Nerv Ment Dis. 1988;176:351–358
  3. Wulsin LR, Yingling K. Psychiatric aspects of chest pain in the emergency department. Med Clin North Am. 1991;75:1175–1188
  4. Beitman BD, Kushner MG, Basha I, Lamberti J, Mukerji V, Bartels K. Follow-up status of patients with angiographically normal coronary arteries and panic disorder. JAMA. 1991;265:1545–1549
  5. Lantinga LJ, Sprafkin RP, McCroskery JH, Baker MT, Warner RA, Hill NE. One-year psychosocial follow-up of patients with chest pain and angiographically normal coronary arteries. Am J Cardiol. 1988;62:209–213
  6. Speckens AE, van Hemert AM, Spinhoven P, Hawton KE, Bolk JH, Rooijmans HG. Cognitive behavioural therapy for medically unexplained symptoms: a randomized controlled trial. Br Med J. 1995;311:1328–1332
  7. Potts SG, Bass CM. Psychosocial outcome and use of medical resources in patients with chest pain and normal or near-normal coronary arteries: a long-term follow-up study. QJM. 1993;86:583–593
  8. Prins JB, Bleijenberg G, Bazelmans E, de Boo TM, Severens JL, van der Wilt GJ, et al. Cognitive behaviour therapy for chronic fatigue syndrome: a multicentre randomised controlled trial. Lancet. 2001;357:841–847
  9. Greeven A, van Balkom AJ, Visser S, Merkelbach JW, van Rood YR, van Dyck R, et al. Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a randomized controlled trial. Am J Psychiatry. 2007;164:91–99
  10. Campbell KS, Skerritt P. Psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy (Review). Cochr Lib. 2006;1:1–30
  11. Cannon RO, Quyyumi AA, Mincemoyer R, Stine AM, Gracely RH, Smith WB, et al. Imipramine in patients with chest pain despite normal coronary angiograms. N Eng J Med. 1994;330:1411–1417
  12. Onghena P, Van Houdenhove B. Antidepressant-induced analgesia in chronic nonmalignant pain: a meta-analysis of 39 placebo-controlled studies. Pain. 1992;49:205–209
  13. Bakker A, van Dyck R, Spinhoven P, van Balkom AJ. Paroxetine, clomipramine, and cognitive therapy in the treatment of panic disorder. J Clin Psychiatry. 1999;60:831–838
  14. Varia I, Logue E, O'connor C, Newby K, Wagner HR, Davenport C, et al. Randomized trial of sertraline in patients with unexplained chest pain of noncardiac origin. Am Heart J. 2000;140:367–372
  15. Salkovskis PM. Psychological treatment of noncardiac chest pain: the cognitive approach. Am J Med. 1992;92(Suppl 5A):114–121
  16. Eifert GH. Cardiophobia: a paradigmatic behavioral model of heart-focused anxiety and non-anginal chest pain. Behav Res Ther. 1992;30:329–345
  17. Kraemer HC, Wilson T, Fairburn CG, Agras WS. Mediators and moderators of treatment effects in randomized clinical trials. Arch Gen Psychiatry. 2002;59:877–883
  18. Masand PS, Narasimhan M, Patkar AA. Paroxetine for somatic pain associated with physical illness: A review. Primary Care Companion J Clin Psychiatry. 2006;8:122–130
  19. Fishbain DA, Cutler RB, Rosomoff HL, Rosomoff RS. Do antidepressants have an analgesic effect in psychogenic pain and somatoform pain disorder? A meta-analysis. Psychosom Med. 1998;60:503–509
  20. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psych Scand. 1983;67:361–370
  21. Spinhoven P, Ormel J, Sloekers PP, Kempen GI, Speckens AE, van Hemert AM. A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med. 1997;27:363–370
  22. Eifert GH, Thompson RN, Zvolensky MJ, Edwards K, Frazer N, Haddad JW, et al. The Cardiac Anxiety Questionnaire: development and preliminary validity. Behav Res Ther. 2000;38:1039–1053
  23. Sheehan DV, Janays J, Baker R, Harnett-Sheehan K, Knapp E, Sheehan M, et al. MINI—Mini International Neuropsychiatric Interview—English Version 5.0.0—DSM-IV. J Clin Psychiatry. 1998;59:34–57
  24. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janays J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59:22–33
  25. van Vliet IM, de Beurs E. Het MINI Internationaal Neuropsychiatrisch Interview (MINI). Een kort gestructureerd diagnostisch psychiatrisch interview voor DSM-IV en ICD-10 stoornissen (The MINI International Neuropsychiatric Interview (MINI). A short structured diagnostic interview for DSM-IV and ICD-10 disorders), Tijdschr Psychiatr. 2007;49:393–397
  26. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: Eds; 1994;
  27. van Peski-Oosterbaan AS, Spinhoven P, van Rood Y, van der Does AJ, Bruschke AV, Rooijmans HG. Cognitive-behavioral therapy for noncardiac chest pain: a randomized trial. Am J Med. 1999;106:424–429
  28. Clark DM. A cognitive approach to panic. Behav Res Ther. 1986;24:461–470
  29. Barsky AJ, Ahern DK. Cognitive behavior therapy for hypochondriasis: a randomized controlled trial. JAMA. 2004;291:1464–1470
  30. Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–191
  31. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51:1173–1182
  32. Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40:879–891
  33. Burns JW, Kubilus A, Bruehl S, Harden RN. Do changes in cognitive factors influence outcome following multidisciplinary treatment for chronic pain: a cross-lagged panel analysis. J Cons Clin Psychol. 2003;71:81–91
  34. van Peski-Oosterbaan AS, Spinhoven P, van der Does AJ, Bruschke AV. Noncardiac chest pain: interest in a medical psychological treatment. J Psychosom Res. 1998;45:471–476
  35. Turner JA, Holtzman S, Mancl L. Mediators, moderators, and predictors of therapeutic change in cognitive–behavioral therapy for chronic pain. Pain. 2007;127:276–286
  36. van Peski-Oosterbaan AS, Spinhoven P, van der Does AJ, Bruschke AV, Rooijmans HG. Cognitive change following cognitive therapy for non-cardiac chest pain. Psychother Psychosom. 1999;68:214–220
  37. DeRubeis RJ, Evans MD, Hollon SD, Garvey MJ, Grove WM, Tuason VB. How does cognitive therapy work? Cognitive change and symptom change in cognitive therapy and pharmacotherapy for depression. J Cons Clin Psychol. 1990;58:862–869
  38. Rush AJ, Kovacs M, Beck AT, Weissenburger J, Hollon SD. Differential effects of cognitive therapy and pharmacotherapy on depressive symptoms. J Affect Disorders. 1981;3:221–229
  39. Simons AD, Garfield SL, Murphy GE. The process of change in cognitive therapy and pharmacotherapy for depression. Arch Gen Psychiatry. 1984;41:45–51

PII: S0022-3999(10)00077-2

doi: 10.1016/j.jpsychores.2010.02.005

Journal of Psychosomatic Research
Volume 69, Issue 3 , Pages 227-235 , September 2010

Article Tools

* Image Usage & Resolution