title: Health care utilization and psychosocial factors in pediatric noncardiac chest pain.
abstract: OBJECTIVE
  This study investigated factors related to health care utilization (HCU) among patients presenting to pediatric cardiologists with symptoms of chest pain later diagnosed as noncardiac chest pain (NCCP).
  
  
  METHODS
  Participants included 67 children and adolescents diagnosed with NCCP and their parent. Measures of HCU, pain severity, and child self-report and parent self-report of anxiety and depression were collected at the cardiologist's office. The child's sex was examined as a moderator of HCU.
  
  
  RESULTS
  Pain severity and maternal and child depression were significant contributors to the variance in child HCU. The relationship between depression and HCU was moderated by the child's sex, with boys higher in levels of maternal or child depression reporting greater HCU.
  
  
  CONCLUSIONS
  Psychological factors are related to HCU for children with NCCP, with depression positively associated with HCU. The child's sex plays an important role in depression and HCU. Family-focused psychological screening of pediatric patients with NCCP may aid in identifying families who may benefit from referrals for psychological assessment and treatment.
authors.affiliation: Department of Psychology, University of Georgia, Athens, GA 30602, USA. jenlee09@uga.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Lee
authors.forename: Jordan
authors.initials: J
authors.lastname: Gilleland
authors.forename: Robert M
authors.initials: RM
authors.lastname: Campbell
authors.forename: Patricia
authors.initials: P
authors.lastname: Simpson
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Johnson
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Dooley
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Blount
mesh_terms: D000293:Adolescent; D001007:Anxiety; D002637:Chest Pain / Q000523:psychology / Q000628:therapy*; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D057566:Self Report; D012720:Severity of Illness Index; D012737:Sex Factors; D013315:Stress, Psychological