Internet-delivered cognitive behavioural therapy for patients with non-cardiac chest pain (IKSIT)

Studies have shown that psychological distress – such as depressive symptoms, cardiac anxiety (i.e. anxiety over having a heart disease), and fear of bodily symptoms – occurs frequently in this patient group. We have also found that psychological distress, and in particular cardiac anxiety, is highly related to increased healthcare utilization, and therefore increased costs. Thus, the treatment of psychological distress may reduce patient problems, and in this way also the healthcare utilization.

We believe that these patients need to change their patterns of thought that are related to their chest pain, acquire increased knowledge about chest pain, and understand that chest pain may have many other causes than the heart. Furthermore, these patients need to be convinced that the heart can cope with physical exertion, so that they do not avoid physical activity, which they often consider to be harmful for the heart. In addition, the patients need tools to manage recurrent chest pain episodes, which are often associated with stress and anxiety.

In order to learn to manage chest pain and not limit themselves in their everyday life, the internet-CBT treatment is based on psychoeducation, exposure to physical activity, exercises in mindfulness and acceptance. The project is ongoing with patient recruitment for the RCT study, and the plan is to have 126 patients included and randomized by the summer of 2025.

Recruitment of study participants takes place via social media and people who meet the criteria can participate regardless of where they live in Sweden. Health economic data will be requested from the regions to which these people belong.