title: Effects of coping skills training and sertraline in patients with non-cardiac chest pain: a randomized controlled study.
abstract: Non-cardiac chest pain (NCCP) is a common and distressing condition. Prior studies suggest that psychotropic medication or pain coping skills training (CST) may benefit NCCP patients. To our knowledge, no clinical trials have examined the separate and combined effects of CST and psychotropic medication in the management of NCCP. This randomized clinical trial examined the separate and combined effects of CST and antidepressant medication (sertraline) in participants with non-cardiac chest pain. A sample of individuals diagnosed with NCCP was randomly assigned to one of four treatments: (1) CST plus sertraline (CST+sertraline), (2) CST plus placebo (CST+placebo), (3) sertraline alone, or (4) placebo alone. Assessments of pain intensity, pain unpleasantness, anxiety, pain catastrophizing, depression, and physical disability were collected prior to treatment, and at 10- and 34-weeks following randomization. Data analyses revealed that CST and sertraline either alone or in combination significantly reduced pain intensity and pain unpleasantness. The combination of CST plus sertraline may have the greatest promise in that, when compared to placebo alone, it not only significantly reduced pain but also pain catastrophizing and anxiety. Overall, these findings support the importance of further research on the effects of CST and sertraline for non-cardiac chest pain.
authors.affiliation: Duke University Medical Center, USA North Carolina Central University, Dept. of Psychology, USA Duke Clinical Research Institute, USA University College Cork, Ireland University of Alabama at Birmingham, USA.
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Shelby
authors.forename: Tamara J
authors.initials: TJ
authors.lastname: Somers
authors.forename: Indira
authors.initials: I
authors.lastname: Varia
authors.forename: Michael
authors.initials: M
authors.lastname: Blazing
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Waters
authors.forename: Daphne
authors.initials: D
authors.lastname: McKee
authors.forename: Susan
authors.initials: S
authors.lastname: Silva
authors.forename: Lelin
authors.initials: L
authors.lastname: She
authors.forename: James A
authors.initials: JA
authors.lastname: Blumenthal
authors.forename: John
authors.initials: J
authors.lastname: O'Connor
authors.forename: Verena
authors.initials: V
authors.lastname: Knowles
authors.forename: Paige
authors.initials: P
authors.lastname: Johnson
authors.forename: Lawrence
authors.initials: L
authors.lastname: Bradley
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001007:Anxiety / Q000209:etiology; D001521:Behavior Therapy / Q000379:methods*; D002637:Chest Pain / Q000150:complications / Q000188:drug therapy / Q000523:psychology / Q000534:rehabilitation; D003863:Depression / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D013811:Psychotherapeutic Processes; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline