title: Complaints of neurotic patients that are of interest for a cardiologist.
abstract: BACKGROUND
  Patients in various areas of medicine report symptoms that are unexplained by other medical reasons than psychological/psychiatric. Some of them urgently seek treatment due to cardiovascular complaints, mostly rapid heart rate, palpitations and chest pain. Typical cardiac investigations, usually showing no organic reasons for these conditions, bring little information about stressful life events and psychological predispositions of these patients. Identification of coexistence of "cardiac" symptoms with other symptoms typical for neurotic disorders and difficult life circumstances may facilitate not only psychiatric diagnosis but also evaluation by cardiologists, primary care physicians, and other specialists.
  
  
  OBJECTIVE
  To determine the psychosocial context of psychogenic "pseudocardiac" symptoms and their coexistence with other symptoms in patients with neurotic disorders.
  
  
  METHODS
  Medical records of patients from the years 1980-2002 that included self-administered questionnaires transformed into an anonymised database were examined. An analysis of the relationship between symptoms reported in the Symptom Checklist and biographical circumstances described in the Life Inventory before admission to a psychotherapy day clinic for patients with neurotic disorders was performed using simple logistic regression with estimation of odds ratios and their 95% confidence intervals.
  
  
  RESULTS
  The symptoms of tachycardia/palpitations and chest pain were very common, present in most subjects, and were significantly associated with such circumstances as suboptimal conflict solving by passive aggression or quarrels, uncertainty in the relationship, a sense of being inferior to the partner, and poor financial situation. In addition, these "pseudocardiac" symptoms were also associated with such childhood reminiscences as origin from a large low income family, feeling that the family of origin was inferior to others, and experience of parental hostility or lack of support.
  
  
  CONCLUSIONS
  Physicians of all specialties who deal with patients experiencing pseudocardiac symptoms should expect their psychological background and perform a simple interview to identify the presence of adverse biographical circumstances described above. Identification and discussing these difficult experiences with the patients may help to convince them to seek psychological support or psychotherapy.
authors.affiliation: Katedra Psychoterapii Collegium Medicum UJ. molocko@poczta.fm.
authors.forename: Jerzy A
authors.initials: JA
authors.lastname: Sobański
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Klasa
authors.forename: Lech
authors.initials: L
authors.lastname: Popiołek
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Rutkowski
authors.forename: Edyta
authors.initials: E
authors.lastname: Dembińska
authors.forename: Michał
authors.initials: M
authors.lastname: Mielimąka
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Cyranka
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Müldner-Nieckowski
authors.forename: Bogna
authors.initials: B
authors.lastname: Smiatek-Mazgaj
authors.forename: Paweł
authors.initials: P
authors.lastname: Rodziński
mesh_terms: D000293:Adolescent; D002637:Chest Pain / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009497:Neurotic Disorders; D011044:Poland; D011602:Psychophysiologic Disorders; D011795:Surveys and Questionnaires; D013610:Tachycardia / Q000523:psychology*; D055815:Young Adult
keywords: frequent complaints; medically unexplained symptoms; psychocardiology; psychogenic chest pain; psychogenic tachycardia