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

Helen Jones ¹, Patricia Cooper ², Vivien Miller ^2*, Nicholas Brooks ² and Peter J Whorwell ¹

¹ University of Manchester, United Kingdom
² University Hospital of South Manchester, United Kingdom

^* To whom correspondence should be addressed. E-mail: vivien.miller{at}smuht.nwest.nhs.uk.

Accepted 16 March 2006

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 & Methods: 28 patients fulfilling the entry criteria were randomised to receive, after a four week baseline, either 12 sessions of hypnotherapy or supportive therapy plus placebo medication, over a seventeen week period. The primary outcome measure was a 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: 12 of 15 (80%) hypnotherapy patients versus 3 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 wellbeing 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 utility in this highly selected group of NCCP patients and warrants further assessment in the broader context of this disorder.

Keywords: hypnosis, non cardiac chest pain

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