Noncardiac chest pain in the emergency department: the role of cardiac history, anxiety or depression and Type D personality
- PMID: 17446807
- DOI: 10.1097/HJR.0b013e32801da0fc
Noncardiac chest pain in the emergency department: the role of cardiac history, anxiety or depression and Type D personality
Abstract
Background: Noncardiac chest pain is common in patients presenting to emergency departments and is frequently associated with panic disorder. This can represent a major burden for patients and the healthcare system. Little is known about the patient characteristics that increase the risk of noncardiac chest pain. We examined whether cardiac history or Type D personality was associated with panic disorder and/or depression-driven noncardiac chest pain.
Methods and results: Patients presenting with noncardiac chest pain to the emergency department of the University Hospital Maastricht were screened using the Hospital Anxiety and Depression Scale (HADS). Patients scoring > or =8 on the HADS subscale were invited for a psychiatric interview; a consecutive sample of patients scoring <8 on the HADS was included as a reference group. Type D personality (tendency to experience emotional distress) was assessed with the DS14. Among the 304 HADS-positive patients, 89% were diagnosed with panic disorder/depression as compared with 8% of the 106 HADS-negative patients. Previous cardiac history was not associated with psychiatric diagnosis. Type D patients reported more anxiety symptoms (12.4+/-4.0 vs. 8.1+/-4.9) and depression symptoms on the HADS (10.2+/-4.7 vs. 5.8+/-4.9) and more often had comorbid panic disorder/depression (91/157=58% vs. 57/253=23%) than non-Type D patients (P<0.0001). Type D personality (odds ratio =8.67, 95% confidence interval 4.69-16.02), younger age and male sex were independently associated with increased risk of panic disorder or depression. Type D was independently associated with comorbid panic disorder/depression (odds ratio=14.49).
Conclusion: Type D personality, but not cardiac history, is independently associated with the presence of psychopathology in noncardiac chest pain. Type D is associated with a substantially increased risk of co-occurring PD/depression in these patients.
Similar articles
-
[Panic disorder, chest pain and palpitations: a pilot study of a Dutch First Heart Aid].Ned Tijdschr Geneeskd. 2000 Apr 15;144(16):745-9. Ned Tijdschr Geneeskd. 2000. PMID: 10812442 Dutch.
-
A brief cognitive-behavioral intervention for treating depression and panic disorder in patients with noncardiac chest pain: a 24-week randomized controlled trial.Depress Anxiety. 2013 Jul;30(7):670-8. doi: 10.1002/da.22106. Epub 2013 Apr 26. Depress Anxiety. 2013. PMID: 23625592 Clinical Trial.
-
Panic disorder in emergency department chest pain patients: prevalence, comorbidity, suicidal ideation, and physician recognition.Am J Med. 1996 Oct;101(4):371-80. doi: 10.1016/S0002-9343(96)00224-0. Am J Med. 1996. PMID: 8873507
-
[Panic disorder in patients with chest pain and palpitations: an often unrecognized relationship].Ned Tijdschr Geneeskd. 2000 Apr 15;144(16):732-6. Ned Tijdschr Geneeskd. 2000. PMID: 10812439 Review. Dutch.
-
Chest pain of cardiac and noncardiac origin.Metabolism. 2010 Oct;59 Suppl 1:S41-6. doi: 10.1016/j.metabol.2010.07.014. Metabolism. 2010. PMID: 20837193 Review.
Cited by
-
Taking Heart: Cardiac Symptoms and Nightmares Differentiate Nightmare Proneness and Psychological Distress among Young Adults.Sleep Sci. 2023 Apr 19;16(1):59-67. doi: 10.1055/s-0043-1767752. eCollection 2023 Mar. Sleep Sci. 2023. PMID: 37151775 Free PMC article.
-
Which symptoms are the psychopathological core affecting the manifestation of pseudo-cardiac symptoms and poor sleep quality in young adults? Symptoms of personality disorders versus clinical disorders.Front Psychol. 2022 Dec 9;13:1011737. doi: 10.3389/fpsyg.2022.1011737. eCollection 2022. Front Psychol. 2022. PMID: 36571031 Free PMC article.
-
Determinants of depression in non-cardiac chest pain patients: a cross sectional study.Korean J Pain. 2021 Oct 1;34(4):417-426. doi: 10.3344/kjp.2021.34.4.417. Korean J Pain. 2021. PMID: 34593659 Free PMC article.
-
Type D Personality and Health-Related Quality of Life in Vascular Surgery Patients.Int J Behav Med. 2019 Aug;26(4):343-351. doi: 10.1007/s12529-018-09762-3. Int J Behav Med. 2019. PMID: 31264102 Free PMC article.
-
Role of personality in cardiovascular diseases: An issue that needs to be focused too!Indian Heart J. 2018 Dec;70 Suppl 3(Suppl 3):S471-S477. doi: 10.1016/j.ihj.2018.11.003. Epub 2018 Nov 8. Indian Heart J. 2018. PMID: 30595309 Free PMC article. Review.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical