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Treatment of non-cardiac chest pain: a controlled trial of hypnotherapy

Departments of Medicine and Cardiology, Wythenshawe Hospital, Manchester, UK

Correspondence to:
Correspondence to:
Professor P J Whorwell
Education and Research Centre, Wythenshawe Hospital, Southmoor Rd, Wythenshawe, Manchester M23 9LT, UK; Peter.Whorwell{at}smuht.nwest.nhs.uk

ABSTRACT
Background: Non-cardiac chest pain (NCCP) is an extremely debilitating condition of uncertain origin which is difficult to treat and consequently has a high psychological morbidity. Hypnotherapy has been shown to be effective in related conditions such as irritable bowel syndrome where its beneficial effects are long lasting.

Aims: This study aimed to assess the efficacy of hypnotherapy in a selected group of patients with angina-like chest pain in whom coronary angiography was normal and oesophageal reflux was not contributory.

Patients and methods: Twenty eight patients fulfilling the entry criteria were randomised to receive, after a four week baseline period, either 12 sessions of hypnotherapy or supportive therapy plus placebo medication over a 17 week period. The primary outcome measure was global assessment of chest pain improvement. Secondary variables were a change in scores for quality of life, pain severity, pain frequency, anxiety, and depression, as well as any alteration in the use of medication.

Results: Twelve of 15 (80%) hypnotherapy patients compared with three of 13 (23%) controls experienced a global improvement in pain (p = 0.008) which was associated with a significantly greater reduction in pain intensity (p = 0.046) although not frequency. Hypnotherapy also resulted in a significantly greater improvement in overall well being in addition to a reduction in medication usage. There were no differences favouring hypnotherapy with respect to anxiety or depression scores.

Conclusion: Hypnotherapy appears to have use in this highly selected group of NCCP patients and warrants further assessment in the broader context of this disorder.

Abbreviations: NCCP, non-cardiac chest pain; IBS, irritable bowel syndrome; QOL, quality of life; HAD, hospital anxiety depression

Keywords: hypnosis; non-cardiac chest pain

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O S Palsson and W E Whitehead
Gut 2006 55: 1381-1384. [Extract] [Full Text] [PDF]

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				V Miller, H Jones, and P J Whorwell Hypnotherapy for non-cardiac chest pain: long-term follow-up Gut, November 1, 2007; 56(11): 1643 - 1643. [Full Text] [PDF]

				Hypnotherapy relieves non-cardiac chest pain BMJ, November 11, 2006; 333(7576): 1012 - 1012. [Full Text] [PDF]

				O S Palsson and W E Whitehead Hypnosis for non-cardiac chest pain. Gut, October 1, 2006; 55(10): 1381 - 1384. [Full Text] [PDF]