title: Guided Internet-delivered cognitive behavioural therapy in patients with non-cardiac chest pain - a pilot randomized controlled study.
abstract: Patients with recurrent episodes of non-cardiac chest pain may experience cardiac anxiety and avoidance behavior, leading to increased healthcare utilization. These patients might benefit from help and support to evaluate the perception and management of their chest pain. The purpose of this study was to test the feasibility of a short guided Internet-delivered cognitive behavioural therapy (CBT) program and explore the effects on cardiac anxiety, fear of body sensations, depressive symptoms, and chest pain in patients with non-cardiac chest pain, compared with usual care.
  
  
  
  A pilot randomized controlled study was conducted. Fifteen patients with non-cardiac chest pain with cardiac anxiety or fear of body sensations, aged 22-76 years, were randomized to intervention (n = 7) or control (n = 8) groups. The four-session CBT program contained psychoeducation, physical activity, and relaxation. The control group received usual care. Data were collected before and after intervention.
  
  
  
  Five of seven patients in the intervention group completed the program, which was perceived as user-friendly with comprehensible language, adequate and varied content, and manageable homework assignments. Being guided and supported, patients were empowered and motivated to be active and complete the program. Patients in both intervention and control groups improved with regard to cardiac anxiety, fear of body sensations, and depressive symptoms, but no significant differences were found between the groups.
  
  
  
  The Internet-delivered CBT program seems feasible for patients with non-cardiac chest pain, but needs to be evaluated in larger groups and with a longer follow-up period.
  
  
  
  Clinicaltrials.gov NCT02336880 . Registered on 8 January 2015.
authors.affiliation: Department of Social and Welfare Studies, Linköping University, Kungsgatan 40, SE-601 74, Norrköping, Sweden. ghassan.mourad@liu.se.
authors.forename: Ghassan
authors.initials: G
authors.lastname: Mourad
authors.affiliation: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.|Department of Cardiology, Linköping University Hospital, Linköping, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Strömberg
authors.affiliation: Department of Psychiatry, More and Romsdal Hospital Trust, Molde, Norway.|Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Egil
authors.initials: E
authors.lastname: Jonsbu
authors.affiliation: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.|Department of Cardiology, Linköping University Hospital, Linköping, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Gustafsson
authors.affiliation: Department of Social and Welfare Studies, Linköping University, Kungsgatan 40, SE-601 74, Norrköping, Sweden.|Department of Cardiology, Linköping University Hospital, Linköping, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Johansson
authors.affiliation: Department of Social and Welfare Studies, Linköping University, Kungsgatan 40, SE-601 74, Norrköping, Sweden.
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002637:Chest Pain / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015444:Exercise; D005239:Fear; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010865:Pilot Projects; D012008:Recurrence; D012064:Relaxation Therapy; D012677:Sensation; D011795:Surveys and Questionnaires; D013548:Sweden; D013813:Therapy, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cardiac anxiety; Cognitive behavioural therapy; Fear of body sensations; Internet-delivered; Non-cardiac chest pain; Randomized controlled study