Unexplained chest pain in the ED: could it be panic?
OBJECTIVE
This study aimed at (1) establishing the prevalence of paniclike anxiety in emergency department (ED) patients with unexplained chest pain (UCP); (2) describing and comparing the sociodemographic, medical, and psychiatric characteristics of UCP patients with and without paniclike anxiety; and (3) measuring the rate of identification of panic in this population.


METHODS
A structured interview, the Anxiety Disorders Interview Schedule for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, was administered to identify paniclike anxiety and evaluate patients' psychiatric status. Anxious and depressive symptoms were evaluated with self-report questionnaires. Medical information was extracted from patients' medical records.


RESULTS
The prevalence of paniclike anxiety was 44% (95% CI, 40%-48%) in the sample (n = 771). Psychiatric disorders were more common in panic patients (63.4% vs 20.1%), as were suicidal thoughts (21.3% vs 11.3%). Emergency physician diagnosed only 7.4% of panic cases.


CONCLUSIONS
Paniclike anxiety is common in ED patients with UCP, and this condition is rarely diagnosed in this population.
Foldes-Busque
Guillaume
G
Department of Psychology, Université du Québec à Montréal, Quebec, Canada. guill.foldesbusque@videotron.ca
Marchand
André
A
Chauny
Jean-Marc
JM
Poitras
Julien
J
Diodati
Jean
J
Denis
Isabelle
I
Lessard
Marie-Josée
MJ
Pelland
Marie-Ève
MÈ
Fleet
Richard
R
D000704:Analysis of Variance; D002637:Chest Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D016009:Chi-Square Distribution; D002985:Clinical Protocols; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires