title: Anxiety of patients undergoing CT imaging-an underestimated problem?
abstract: OBJECTIVE
  Prospective evaluation of anxiety in patients undergoing computed tomography (CT) imaging using a standardized state-trait anxiety inventory (STAI-S) and identification of possible risk factors.
  
  
  METHODS
  During a 9-month interval, patients undergoing CT were questioned using STAI-S. Additionally, 10 questions concerning specific procedure-related features (claustrophobia, radiation, administration of contrast, and so forth) were added. Moreover, sex, age, admitting subspecialty, organ region, reason for imaging, and prior imaging studies were recorded. Statistical analysis was performed using the Student t test and linear regression analysis; significance level was set to 5%.
  
  
  RESULTS
  Of 6122 patients, 825 patients undergoing CT (14%) were included (67% men; average age, 54 ± 17 years). Average STAI was 42 ± 10 with women (45 ± 11 vs. 41 ± 10; P < .001) and patients who received intravenous contrast (43 ± 10 vs. 42 ± 11; P = .021) showing significantly higher anxiety levels compared to those without contrast. Patients with investigations of their extremities (41 ± 11 vs. 43 ± 10; P = .020) and trauma patients (41 ± 11 vs. 43 ± 10; P = .006) revealed significantly lower STAI results. Patients who had never received a CT scan before showed significantly greater STAI-S values than those with repeat studies (42 ± 10 vs. 41 ± 11; P = .036). Females had greater fears concerning examination results (P < .001), radiation exposure (P = .032), administration of contrast (P = .014), and claustrophobia (P < .001). Patients with known malignancies had a significantly higher level of anxiety concerning their CT results (P = .002).
  
  
  CONCLUSIONS
  Anxiety does not only occur before MRI but also occur before CT. Its sources are manifold and include communication of CT results, administration of contrast agents, radiation exposure, and claustrophobia. In this setting, women seemed to be more receptive than men.
authors.affiliation: Institute of Diagnostic Radiology, Interventional Radiology and Nuclear Medicine, Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil, Ruhr-University of Bochum, Bürkle-de-la-Camp Platz 1, D-44789 Bochum, Germany. Electronic address: christoph.heyer@rub.de.
authors.forename: Christoph M
authors.initials: CM
authors.lastname: Heyer
authors.affiliation: Institute of Diagnostic Radiology, Interventional Radiology and Nuclear Medicine, Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil, Ruhr-University of Bochum, Bürkle-de-la-Camp Platz 1, D-44789 Bochum, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Thüring
authors.affiliation: Institute of Diagnostic Radiology, Interventional Radiology and Nuclear Medicine, Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil, Ruhr-University of Bochum, Bürkle-de-la-Camp Platz 1, D-44789 Bochum, Germany.
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Lemburg
authors.affiliation: Department of Medical Psychology and Medical Sociology, Ruhr-University of Bochum, Bochum, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Kreddig
authors.affiliation: Department of Medical Psychology and Medical Sociology, Ruhr-University of Bochum, Bochum, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Hasenbring
authors.affiliation: Institute of Radiology and Neuroradiology, Alfried Krupp Krankenhaus Essen, Essen, Germany.
authors.forename: Martha
authors.initials: M
authors.lastname: Dohna
authors.affiliation: Institute of Diagnostic Radiology, Interventional Radiology and Nuclear Medicine, Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil, Ruhr-University of Bochum, Bürkle-de-la-Camp Platz 1, D-44789 Bochum, Germany.
authors.forename: Volkmar
authors.initials: V
authors.lastname: Nicolas
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology*; D015984:Causality; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D010698:Phobic Disorders / Q000453:epidemiology / Q000523:psychology*; D011832:Radiation Injuries / Q000453:epidemiology / Q000523:psychology*; D012307:Risk Factors; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Computed tomography; anxiety; contrast agent; radiation exposure