Psychological treatments for noncardiac chest pain: recommendations for a new approach.
OBJECTIVE
Our objective is to describe the current state of treatment for NCCP, identify barriers to treatment and limitations of current approaches, and to recommend treatment strategies, which may address these challenges.


METHODS
We describe the underlying rationale for treating NCCP and review the current literature concerning NCCP treatments and other brief approaches to outpatient treatment for psychosomatic illness.


RESULTS
Most treatments for NCCP have been based on the Attribution Model. Although effective, these treatments are appropriate and acceptable to only a small minority of NCCP patients. The Biopsychosocial Model has been used to treat psychosomatic conditions in outpatient groups and may overcome or avoid many of the limitations inherent in current treatment strategies for NCCP.


CONCLUSIONS
We recommend an intervention for NCCP that is brief, would be delivered in the emergency department setting (to take advantage of the Teachable Moment), and which is based on the Biopsychosocial Model.
Esler
Jeanne L
JL
Centers for Behavioral and Preventive Medicine, Miriam Hospital, Brown University Medical School, Coro Building, Suite 500, 1 Hoppin Street, Providence, RI 02903, USA.
Bock
Beth C
BC
D000553:Ambulatory Care / Q000592:standards; D002637:Chest Pain / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004637:Emergency Services, Psychiatric / Q000592:standards*; D006801:Humans; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011602:Psychophysiologic Disorders / Q000145:classification / Q000150:complications / Q000628:therapy*; D014481:United States