title: Factors associated with pain level in non-cardiac chest pain patients with comorbid panic disorder.
abstract: BACKGROUND
  Panic disorder (PD) is highly prevalent in patients with non-cardiac chest pain (NCCP). This study aims to explore the role of psychological factors (PD intensity, anxiety sensitivity, heart-related fear, attention and avoidance) common to NCCP and PD in predicting chest pain levels in patients with both conditions.
  
  
  METHODS
  This association was investigated in emergency department patients with NCCP and PD receiving either evidence-based treatment of PD or treatment as usual. Patients were assessed at baseline and 14 weeks later for post-treatment.
  
  
  RESULTS
  Only heart-focused fear and attention for cardiac sensations independently explained a significant portion of the variance in baseline pain (n= 66). At 3 months follow-up (n= 53), changes in heart-related fear was the only factor independently associated with changes in chest pain intensity. Even in patients with PD, fear specific to cardiac sensations seems to play a central role in determining NCCP intensity.
  
  
  CONCLUSIONS
  These results suggest that the efficacy of intervention for patients with PD and comorbid NCCP could be improved by targeting heart-related fear and attention.
  
  
  BACKGROUND
  NCT00736346.
authors: School of Psychology, Université Laval, 2325, rue des Bibliothèques, Bureau 1116, Québec, G1V 0A6 Canada ; Research Centre of the University Affiliated Hospital Hôtel-Dieu de Lévis, 143 rue Wolfe, Lévis, Québec G6V 3Z1 Canada.
authors: Guillaume
authors: G
authors: Foldes-Busque
authors: School of Psychology, Université Laval, 2325, rue des Bibliothèques, Bureau 1116, Québec, G1V 0A6 Canada ; Research Centre of the University Affiliated Hospital Hôtel-Dieu de Lévis, 143 rue Wolfe, Lévis, Québec G6V 3Z1 Canada.
authors: Stéphanie
authors: S
authors: Hamel
authors: School of Psychology, Université Laval, 2325, rue des Bibliothèques, Bureau 1116, Québec, G1V 0A6 Canada.
authors: Geneviève
authors: G
authors: Belleville
authors: Research Chair in Emergency Medicine of Laval University, University Affiliated Hospital Hôtel-Dieu de Lévis, 143 rue Wolfe, Lévis, Québec G6V 3Z1 Canada ; Department of Family and Emergency Medicine, Université Laval, 1050 Avenue de la Médecine, Bureau 4617, Québec, G1V 0A6 Canada.
authors: Richard
authors: R
authors: Fleet
authors: Research Centre of the University Affiliated Hospital Hôtel-Dieu de Lévis, 143 rue Wolfe, Lévis, Québec G6V 3Z1 Canada ; Department of Family and Emergency Medicine, Université Laval, 1050 Avenue de la Médecine, Bureau 4617, Québec, G1V 0A6 Canada.
authors: Julien
authors: J
authors: Poitras
authors: Research Centre, Montreal Sacré-Coeur Hospital, 5400 Boulevard Gouin Ouest, local K-3000, Montréal, Québec H4J 1C5 Canada.
authors: Jean-Marc
authors: JM
authors: Chauny
authors: Research Centre, Montreal Heart Institute, 5000 rue Bélanger, Montréal, Québec H1T 1C8 Canada.
authors: Alain
authors: A
authors: Vadeboncoeur
authors: Research Centre, Montreal Sacré-Coeur Hospital, 5400 Boulevard Gouin Ouest, local K-3000, Montréal, Québec H4J 1C5 Canada ; Research Centre, Montreal Heart Institute, 5000 rue Bélanger, Montréal, Québec H1T 1C8 Canada ; Psychology Department, Université du Québec à Montréal, C.P. 8888 succursale Centre-ville, Montréal, Québec H3C 3P8 Canada.
authors: Kim L
authors: KL
authors: Lavoie
authors: Psychology Department, Université du Québec à Montréal, C.P. 8888 succursale Centre-ville, Montréal, Québec H3C 3P8 Canada ; Fernand-Séguin Research Centre, Louis-Hippolyte Lafontaine Hospital, 7331 rue Hochelaga, Montréal, Québec H1N 3V2 Canada.
authors: André
authors: A
authors: Marchand
keywords: Anxiety sensitivity; Cardiac anxiety; Chest pain; Heart-focused anxiety; Non-cardiac chest pain; Panic disorder