The purpose of this study is to determine whether care as usual or intervention (consisting of sertraline versus placebo), are effective in the treatment of panic disorder and/or depression driven noncardiac chest pain.

Noncardiac chest pain remains an important problem in clinical cardiology. Often, panic disorder and/or depression are the underlying cause. However, this is largely underdiagnosed.

There are no clear existing treatment strategies/methods for this specific patient population.

In our double blind, placebo controlled care as usual versus sertraline study, we want to investigate whether intervention is more effective as care as usual for diminishing chest pain, and also if sertraline is more effective in this specific population compared to placebo.

Inclusion Criteria:

• chest pain without a cardiac cause
• diagnosed with panic disorder and or depression according to Diagnostic and statistical Manual (DSM) IV criteria
• Living < 50 km from the hospital
• informed consent

Exclusion Criteria:

• other primary DSM IV diagnosis
• known sensitivity to sertraline
• using other anti-depressive agents
• not speaking dutch language
• living in a nursery home or having dementia
• other severe, acute or progressive disease, kidney or liver-function disturbances, pregnancy or breastfeeding