title: Psychological factors, pain attribution and medical morbidity in chest-pain patients with and without coronary artery disease.
abstract: This cross-sectional psychiatric and cardiological study compared patients with and without coronary artery disease (CAD) with respect to psychiatric morbidity, psychological factors, pain characteristics, medical morbidity and the prevalence of coronary risk factors. The 199 participants had been referred to cardiological outpatient clinics for the investigation of chest pain and had no history of heart disease. Current panic disorder occurred significantly more often in non-CAD patients (41% vs. 22%). No significant differences were found for other psychiatric disorders and psychological variables. Non-CAD patients reported significantly longer histories of pain and a higher prevalence of atypical chest pain. In other respects, there were surprisingly few differences between the groups. High morbidity of both psychiatric disease (pain disorder, 19%; any current psychiatric disorder, 72%) and somatic conditions (musculoskeletal disease, 33%; dyspepsia, 23%) was found with no significant differences between the groups. In these patients, multifactorial complaints may explain chest pain in both patient groups. The physicians should attend to psychiatric disorders in non-CAD as well as in CAD patients.
authors.affiliation: Department of Psychiatry, Ullevål University Hospital, N-0407 Oslo, Norway. toril.dammen@medisin.uio.no
authors.forename: Toril
authors.initials: T
authors.lastname: Dammen
authors.forename: Harald
authors.initials: H
authors.lastname: Arnesen
authors.forename: Oivind
authors.initials: O
authors.lastname: Ekeberg
authors.forename: Svein
authors.initials: S
authors.lastname: Friis
mesh_terms: D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D015897:Comorbidity; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D003937:Diagnosis, Differential; D004415:Dyspepsia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007389:Internal-External Control; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010147:Pain Measurement; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D013315:Stress, Psychological / Q000150:complications