Psychiatric morbidity and the presence and absence of angiographic coronary disease in patients with chest pain.
OBJECTIVE
To assess psychiatric morbidity in coronary angiogram patients.


METHODS
A psychiatric assessment of 200 consecutive chest-pain patients was performed the day before coronary angiography in a double-blind study design. The sample included 132 men (mean age 57.2 years, SD 9.5) and 68 women (mean age 59.8 years, SD 8.9). A Structured Clinical Interview for DSM-III-R was used to obtain psychiatric diagnosis. The 21-item Beck Depression Inventory, the 20-item Toronto Alexithymia Scale and a four-item Life Satisfaction Scale were used to assess mental symptoms. A coronary angiography with obstruction of a coronary artery by more than 50% was considered to indicate angiographic coronary disease.


RESULTS
Mental disorders were found in 28% (95% CI 14-41) of the patients with normal angiographic findings (n=47) and in 24% (95% CI 17 - 30) of the patients with angiographic coronary disease (n=153). Furthermore, no difference was found between these two groups in other rating scales assessing mental symptoms even when adjusted for the New York Heart Association class, duration of chest-pain symptoms or exercise capacity.


CONCLUSIONS
Psychiatric morbidity may not be associated with angiographic findings in patients with chest pain.
Valkamo
M
M
Department of Psychiatry, Kuopio University Hospital, FI-70211 Kuopio, Finland.
Hintikka
J
J
Niskanen
L
L
Viinamäki
H
H
D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000523:psychology*; D003937:Diagnosis, Differential; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D009449:Neurocirculatory Asthenia / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D013001:Somatoform Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000523:psychology*