Depressive symptoms and healthcare utilization in patients with noncardiac chest pain compared to patients with ischemic heart disease

Abstract

OBJECTIVES: We compared depressive symptoms and healthcare utilization in patients admitted for noncardiac chest pain, acute myocardial infarction, and angina pectoris after hospitalization and at 1-year follow-up. METHODS: One hundred and thirty-one patients with noncardiac chest pain, 66 with acute myocardial infarction, and 70 with angina pectoris completed a depression screening questionnaire and the Montgomery Åsberg Depression Rating Scale. Healthcare utilization data were collected from a population-based, diagnosis-related database. RESULTS: More than 25% of respondents reported depressive symptoms, regardless of diagnosis. At follow-up, 9% had recovered, 19% were still experiencing depressive symptoms, and 13% had developed depressive symptoms. Noncardiac patients with chest pain had similar primary care contacts, but fewer hospital admissions, than patients with an acute myocardial infarction. Patients with angina pectoris and depressive symptoms used the most healthcare services. CONCLUSIONS: Depressive symptoms were common. Patients with noncardiac chest pain used as much primary care as did patients with an acute myocardial infarction. Interventions should focus on identifying and treating depressive symptoms

Depressive Symptoms, Cardiac Anxiety, and Fear of Body Sensations in Patients with Non-Cardiac Chest Pain, and Their Relation to Healthcare-Seeking Behavior: A Cross-Sectional Study

“…This is comparable to our earlier study reporting depressive symptoms in 25 % of the participants with NCCP [15]. The prevalence of depressive symptoms has been found to range from 9 % to 40 % in patients with NCCP [6].…”

“…The prevalence of depressive symptoms has been found to range from 9 % to 40 % in patients with NCCP [6]. Higher levels of depression severity have been found to be associated with an increase in healthcare use [15,26].…”

“…Despite the favourable prognosis [4,5,12,13], patients with NCCP suffer from recurrent chest pain and have been found to use out-patient healthcare to the same extent as patients with cardiac pain [14,15], leading to high healthcare and societal costs [16][17][18][19]. A possible mechanism for this can be psychological distress, although there could be physical causes that have not been detected yet.…”

Illness Perceptions, Negative Emotions, and Pain in Patients with Noncardiac Chest Pain

“…NCCP is also associated with an increased number of missed workdays (Eslick & Talley, 2004), and results show that rates of chest pain-related work absenteeism are similar in NCCP and cardiac disease groups (Cheung et al, 2009). Lastly, NCCP is related to elevated rates of health care utilization (Eslick, 2004;Mourad, Jaarsma, Hallert, & Strömberg, 2012) Patients with NCCP exhibit high levels of psychological distress. Compared to both the general population as well as patients with cardiac disease, individuals with NCCP report more severe anxiety and depression (Fass & Achem, 2011;Webster, Norman, Goodacre, & Thompson, 2012) and are more likely to be diagnosed with a DSM-IV Axis-I disorder (Alexander, Prabhu, Krishnamoorthy, & Halkatti, 1994;Serlie, Erdman, Passchier, Trijsburg, & ten Cate, 1995;White et al, 2008).…”

Risks for cardiovascular disease in middle-aged women in different social environments

“…A higher prevalence of self-reported chest pain was seen in the high level Good Girl group. Another study revealed that patients with unexplained chest pain were likely to be immigrants, they perceived more stress at work and had more symptoms of depression and trait-anxiety compared with the participants in the reference group, even after adjustment for age, smoking, hypertension and diabetes (Mourad et al, 2012). Unfortunately, it is unknown if this refers to cardiac-or non-cardiac chest pain (Mourd et al, 2012, Ono &Falcao, 2016.…”