ANXIETY, DEPRESSION, AND NONCARDIAC CHEST PAIN

焦虑、抑郁和非心源性胸痛

• 批准号: 6872216
• 负责人: Francis J. Keefe
• 金额: $ 54.4万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6872216
• 关键词: anxiety; behavior therapy; behavioral /social science research tag; chronic pain; combination therapy; coping; depression; human subject; human therapy evaluation; mental disorder chemotherapy; patient oriented research; sertraline; thorax

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.

申请人的描述：持续疼痛对许多人来说是一个严重的问题 非心源性胸痛患者。尽管应对技能训练（CST）方法 最近才被应用于治疗非心源性胸痛， 这些方法似乎很有前途。完成 CST 后，许多患者 据报道，疼痛显着减轻，身体和身体状况得到改善 社会心理障碍。然而后续研究的数据表明 虽然有些患者能够在疼痛中维持治疗效果，但其他患者则无法 不是。鉴于 CST 的优点（成本低且副作用最小）和 其已展现出的前景，需要探索新的方法来提供帮助 非心源性胸痛患者维持并延长初始治疗 收益。拟议的研究旨在确定 CST 的影响是否可以 通过与舍曲林（我们拥有的一种精神药物）相结合来增强 最近在初步研究中发现可以显着减轻疼痛 非心源性胸痛患者。在拟议的研究中，200 个非心源性胸部 疼痛患者将被随机分配到四种情况：a) CST plus 舍曲林，b) CST 加安慰剂，c) 单独舍曲林，以及 d) 单独安慰剂。 将在 10 周治疗阶段之前和之后收集结果指标 研究期间和治疗后 6 个月。研究：1）将评估 将 CST 与舍塔林相结合的方案是否有助于患者维持 疼痛、身体残疾、心理社会残疾方面的进展，以及 2) 将 确定患者与疼痛相关的灾难性和日常使用的变化 的应对技能与疼痛和疼痛的长期（6 个月）改善有关 残疾。如果 CST 加舍曲林有效，未来的研究可以评估 该生物行为方案对其他人群的功效 持续性疼痛（例如骨关节炎、镰状细胞病或癌症）。未来 研究还可以确定 CST 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 重组）对治疗效果贡献最大。通过隔离 这一训练的有效成分，可以精简一下。让它变得更多 成本效益高，因此更容易为广大人口所利用 非心源性胸痛患者。该研究建议严格评估 增强应对技能训练和舍曲林效果的方法 非心源性胸痛患者。这项研究可能会给我们带来重大进展 了解非心源性胸痛并扩大我们的方法库 用于有效治疗非心源性胸痛。

项目成果

Pain catastrophizing in patients with noncardiac chest pain: relationships with pain, anxiety, and disability.

非心脏胸痛患者的疼痛灾难性：与疼痛，焦虑和残疾的关系。

• DOI: 10.1097/psy.0b013e3181b49584
• 发表时间: 2009-10
• 期刊: Psychosomatic medicine
• 影响因子: 3.3
• 作者: Shelby RA;Somers TJ;Keefe FJ;Silva SG;McKee DC;She L;Waters SJ;Varia I;Riordan YB;Knowles VM;Blazing M;Blumenthal JA;Johnson P
• 通讯作者: Johnson P

Effects of coping skills training and sertraline in patients with non-cardiac chest pain: a randomized controlled study.

• DOI: 10.1016/j.pain.2010.08.040
• 发表时间: 2011-04
• 期刊: Pain
• 影响因子: 7.4
• 作者: Keefe FJ;Shelby RA;Somers TJ;Varia I;Blazing M;Waters SJ;McKee D;Silva S;She L;Blumenthal JA;O'Connor J;Knowles V;Johnson P;Bradley L
• 通讯作者: Bradley L

Attachment and pain: recent findings and future directions.

依恋和痛苦：最近的发现和未来的方向。

• DOI: 10.1016/j.pain.2007.02.001
• 发表时间: 2007
• 期刊: Pain
• 影响因子: 7.4
• 作者: Porter,LauraS;Davis,Deborah;Keefe,FrancisJ
• 通讯作者: Keefe,FrancisJ