Illness representations, psychological distress and non-cardiac chest pain in patients attending an emergency department.
OBJECTIVE
Many patients who attend an emergency department (ED) with chest pain receive a diagnosis of non-cardiac chest pain (NCCP), and often suffer poor psychological outcomes and continued pain. This study assessed the role of illness representations in explaining psychological distress and continued chest pain in patients attending an ED.


METHODS
ED NCCP patients (N = 138) completed measures assessing illness representations, anxiety, depression and quality of life (QoL) at baseline, and chest pain at one month.


RESULTS
Illness representations explained significant amounts of the variance in anxiety (Adj. R² = .38), depression (Adj. R² = .18) and mental QoL (Adj. R² = .36). A belief in psychological causes had the strongest associations with outcomes. At one month, 28.7% of participants reported experiencing frequent pain, 13.2% infrequent pain and 58.1% no pain. Anxiety, depression and poor QoL, but not illness representations, were associated with continued chest pain.


CONCLUSIONS
The findings suggest that (i) continued chest pain is related to psychological distress and poor QoL, (ii) interventions should be aimed at reducing psychological distress and improving QoL and (iii) given the associations between perceived psychological causes and psychological distress/QoL, NCCP patients in the ED might benefit from psychological therapies to manage their chest pain.
a Department of Psychology , University of Sheffield , Sheffield , UK.
R
R
Webster
P
P
Norman
S
S
Goodacre
A R
AR
Thompson
R R C
RR
McEachan
D000328:Adult; D000368:Aged; D001007:Anxiety; D001294:Attitude to Health; D002637:Chest Pain / Q000523:psychology* / Q000628:therapy; D003863:Depression; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
anxiety; depression; illness representation; non-cardiac chest pain; psychosomatic; quality of life