ANXIETY, DEPRESSION, AND NONCARDIAC CHEST PAIN

申请者描述：持续性疼痛对许多人来说是一个严重的问题 非心源性胸痛患者。尽管应对技能培训(CST)方法 直到最近才被应用于非心源性胸痛的治疗， 这些方法似乎很有前途。完成CST后，许多患者 报告说疼痛显著减少，身体和 心理社会残疾。然而，来自后续研究的数据表明， 虽然一些患者能够在疼痛中保持治疗成果，但另一些患者 不。鉴于CST的优势(其低成本和最小副作用)和 它展示了它的承诺，有必要探索新的帮助方式 非心源性胸痛患者维持并延长初始治疗时间 收获。拟议的研究试图确定CST的影响是否可以 通过将其与舍曲林-我们拥有的一种精神药物-结合使用来增强疗效 最近在初步研究中发现，可以显著减少疼痛 非心源性胸痛患者。在拟议的研究中，200个非心脏胸腔 疼痛患者将被随机分配到四种情况：a)CST+ 舍曲林，b)CST加安慰剂，c)单用舍曲林，d)单用安慰剂。 将在10周的治疗阶段之前和之后收集结果衡量标准 在研究和治疗后6个月。研究：1)将评估 联合应用CST和舍他林的方案是否有助于患者维持 疼痛、身体残疾、心理社会残疾的增加，以及2)将 确定患者与疼痛相关的灾难和日常使用的变化 的应对技能与长期(6个月)改善疼痛和 残疾。如果CST加舍曲林有效，未来的研究可能会评估 这一生物行为方案对其他有 持续性疼痛(如骨关节炎、镰状细胞病或癌症)。未来 研究还可以确定科技委的特定组成部分(例如，培训 注意力转移方法、行为应对策略或认知策略 重组)对治疗效果贡献最大。通过隔离 这种培训的有效成分，一个人可以简化它。让它变得更多 性价比高，因此更容易为广大人口提供 非心源性胸痛患者。该研究提出了严格的评估 提高应对技能训练和舍曲林治疗效果的方法 非心源性胸痛患者。这项研究可能会在我们的 认识非心源性胸痛扩大我们的方法储备 用于有效治疗非心源性胸痛。

APPLICANT'S DESCRIPTION: Persistent pain is a significant problem for many non-cardiac chest pain patients. Although coping skills training (CST) methods have only recently been applied to the management of non-cardiac chest pain, these methods appear to be promising. After completing CST, many patients report significant reductions in pain and improvements in physical and psychosocial disability. Data from follow-up studies, however, indicate that while some patients are able to maintain treatment gains in pain, others are not. Given the advantages of CST (its low cost and minimal side effects) and its demonstrated promise, there is a need to explore new ways to help non-cardiac chest pain patients maintain and extend their initial treatment gains. The proposed study seeks to determine whether the effects of CST can be enhanced by combing it with Sertraline-a psychotropic medication that we have recently found in preliminary research can significantly decrease pain in non-cardiac chest pain patients. In the proposed study, 200 non-cardiac chest pain patients will be randomly assigned to four conditions: a) CST plus Sertraline, b) CST plus placebo, c) Sertraline alone, and d) Placebo alone. Outcome measures will be collected before and after the 10 week treatment phase of the study and at 6-months post-treatment. The study: 1) will evaluate whether a protocol that combines CST with Sertaline helps patients maintain gains in pain, physical disability, psycholosocial disability, and 2) will determine how changes in patients' pain-related catastrophizing and daily use of coping skills relate to long-term (6 months) improvements in pain and disability. If CST plus Sertraline is effective, future studies could evaluate the efficacy of this biobehavioral protocol for other populations having persistent pain (e.g. osteoarthritis, sickle cell disease, or cancer). Future studies could also identify the particular components of CST (e.g. training in attention diversion methods, behavioral coping strategies, or cognitive restructuring) that contribute most to treatment effects. By isolating the active ingredients of this training, one can streamline it. making it more cost-effective and thus more readily available to the large population of non-cardiac chest pain patients. The study proposed rigorously evaluates methods for enhancing the effects of coping skills training and Sertraline in non-cardiac chest pain patients. This study may lead to major advances in our understanding of non-cardiac chest pain and enlarge our repertoire of methods for effectively treating non-cardiac chest pain.