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Change and Impact of Illness Perceptions among Patients with Non-cardiac Chest Pain or Benign Palpitations Following Three Sessions of CBT

Published online by Cambridge University Press:  18 March 2013

Egil Jonsbu ,
Egil W. Martinsen ,
Gunnar Morken ,
Torbjørn Moum  and
Toril Dammen
Egil Jonsbu*
Affiliation:
More and Romsdal Hospital Trust, Molde, and Norwegian University of Science and Technology, Trondheim, Norway
Egil W. Martinsen
Affiliation:
University of Oslo, and Oslo University Hospital, Norway
Gunnar Morken
Affiliation:
Norwegian University of Science and Technology, and St Olavs University Hospital, Trondheim, Norway
Torbjørn Moum
Affiliation:
University of Oslo, Norway
Toril Dammen
Affiliation:
Oslo University Hospital, and University of Oslo, Norway
*
Reprint requests to Egil Jonsbu, Department of Psychiatry, Molde Hospital, 6407 Molde, Norway. E-mail: [email protected]
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Abstract

Background: Many patients with non-cardiac chest pain or benign palpitations have poor prognosis in terms of symptom persistence, limitations in everyday activities, and reduced health-related quality of life (HRQOL). Aims: The aims of the study were to evaluate the changes and impact of illness perceptions during a three-session cognitive behavioural therapy (CBT) intervention for patients with non-cardiac chest pain or benign palpitations. Method: Patients with persistent complaints 6 months after a negative cardiac evaluation were invited to participate in a randomized controlled trial. Patients in the intervention group (n = 21) received three manualized sessions with CBT, including one physical activity exposure session; the control group (n = 19) received usual care from their general practitioner. Brief Illness Perception Questionnaire (BIPQ) was used to measure illness perceptions. Patients were assessed at start and end of the intervention and at 3- and 12-month follow-up. Results: The intervention and control group differed significantly on five of the eight items of BIPQ at least at one follow-up assessment. At end of treatment and at 3-month follow-up change in illness concern (Item 6 in BIPQ) mediated about 40% of the change in depression from baseline, and at 12-month follow-up about 50% of the change in depression was mediated by change in personal control (Item 3 in BIPQ). Conclusion: Illness perceptions measured with BIPQ may mediate the short and long term treatment effects of a three-session CBT-programme for patients with non-cardiac chest pain and benign palpitations.

Keywords

Benign palpitationscognitive behavioural therapyillness perceptionmediator of changenon-cardiac chest painrandomized controlled trial
Type
Empirically Grounded Clinical Interventions
Information
Behavioural and Cognitive Psychotherapy , Volume 41 , Issue 4 , July 2013 , pp. 398 - 407
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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