Personality subtypes and chest pain in patients with nonobstructive coronary artery disease from the TweeSteden Mild Stenosis study: mediating effect of anxiety and depression

Mommersteeg, Paula M.C.; Widdershoven, Jos; Aarnoudse, Wilbert; Denollet, Johan

doi:10.1002/ejp.743

Cited by 11 publications

(13 citation statements)

References 48 publications

(65 reference statements)

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“…In total, 883 patients were eligible for participation and received information on the study, as has previously been described in more detail. 16 In total, 547 (62%) patients signed informed consent, of which 523 completed a set of questionnaires which were send and returned by postal mail. The research protocol was approved by the medical ethics committee of the Elisabeth Hospital Tilburg, and written informed consent was obtained from all participants (METC Brabant protocol number: NL22258.008.08).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Impaired Health Status, Psychological Distress, and Personality in Women and Men With Nonobstructive Coronary Artery Disease

Mommersteeg

Arts

Zijlstra

et al. 2017

Circ: Cardiovascular Quality and Outcomes

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Section: Methodsmentioning

confidence: 99%

“…Type D personality has been associated with poor physical and mental health status 14 , 15 and more chest pain in patients with NOCAD. 16 …”

mentioning

confidence: 99%

Impaired Health Status, Psychological Distress, and Personality in Women and Men With Nonobstructive Coronary Artery Disease

Mommersteeg

Arts

Zijlstra

et al. 2017

Circ: Cardiovascular Quality and Outcomes

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“…For example, veterans with stable CAD and a new diagnosis of depression at follow-up reported more angina, physical limitation and lower treatment satisfaction [24]. Amore recent study in patients with non-obstructive CAD identified an association between type D personality – characterized by negative affective states – and increased frequency of chest pain [13]. We have previously reported that depression in women after myocardial infarction was associated worse angina and physical limitation in addition to worse outcomes [25].…”

Section: Discussionmentioning

confidence: 99%

“…Whether the association between depression and chest pain is dependent on the presence or severity of CAD, or whether this comorbidity is due to other factors, remains unclear. Both pain and depression share common neurochemical pathways [12], and a few studies have suggested that patients with non-obstructive CAD and depression have greater incidence of persistent chest pain [7,13]. Understanding the relation between depression and chest pain is important in order to provide the impetus to study whether treatment of depression improves chest pain, and whether individuals presenting with chest pain should be screened for depression.…”

Section: Introductionmentioning

confidence: 99%

Depression and chest pain in patients with coronary artery disease

Hayek

Awad

et al. 2017

International Journal of Cardiology

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Background Depression is common in patients with coronary artery disease (CAD) and is associated with more frequent chest pain. It is however unclear whether this is due to differences in underlying CAD severity. We sought to determine [1] whether depressive symptoms are associated with chest pain independently of CAD severity, [2] whether improvement in depressive symptoms over time is associated with improvement in chest pain and [3] whether the impact of revascularization on chest pain differs between patients with and without depression. Methods and results 5158 patients (mean age 63 ± 12 years, 65% male, 20% African American) undergoing cardiac catheterization completed the Seattle Angina Questionnaire (SAQ) and Patient Health Questionnaire-8 (PHQ-8) to assess angina severity and screen for depression, respectively, both at baseline and between 6 and 24 months of follow-up. We found significant correlations between PHQ-8 scores and angina frequency (SAQ-AF, r = −0.28), physical limitation (SAQ-PL, r = −0.32) and disease perception (SAQ-DS r = −0.37, all P < 0.001), which remained significant after adjustment for clinical characteristics, CAD severity, and antidepressant use. Improvement in depressive symptoms at follow-up was associated with improvement in angina subscales (SAQ-AF β 1.34, P < 0.001), SAQ-PL β 1.85, P < 0.001), and SAQ-DS (β 2.12, P < 0.001), independently of CAD severity or revascularization. Patients with depression who underwent revascularization had less improvement in chest pain frequency than those without depressive symptoms. Conclusions Depression is associated with angina, independently of CAD severity. Patients with depression may not derive as adequate symptomatic benefit from revascularization as those without. Whether treatment of underlying depression improves chest pain needs to be further studied.

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“…61–64 The TweeSteden Mild Stenosis (TWIST) observational study, as an example, demonstrated an association between type D personality and persistent chest pain. 65 …”

Section: The Psychiatric Differential Diagnosismentioning

confidence: 99%

Non-cardiac Chest Pain: A Review for the Consultation-Liaison Psychiatrist

et al. 2017

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Background Patients presenting with chest pain to general practice or emergency providers represent a unique challenge, as the differential is broad and varies widely in acuity. Importantly, most cases of chest pain in both acute and general practice settings are ultimately found to be non-cardiac in origin, and a substantial proportion of patients experiencing non-cardiac chest pain (NCCP) suffer significant disability. In light of emerging evidence that mental health providers can serve a key role in the care of patients with NCCP, knowledge of the differential diagnosis, psychiatric co-morbidities, and therapeutic techniques for NCCP would be of great use to both consultation-liaison (C-L) psychiatrists and other mental health providers. Methods We reviewed prior published work on (1) the appropriate medical workup of the acute presentation of chest pain, (2) the relevant medical and psychiatric differential diagnosis for chest pain determined to be non-cardiac in origin, (3) the management of related conditions in psychosomatic medicine, and (4) management strategies for patients with NCCP. Results We identified key differential diagnostic and therapeutic considerations for psychosomatic medicine providers in 3 different clinical contexts: acute care in the emergency department, inpatient C-L psychiatry, and outpatient C-L psychiatry. We also identified several gaps in the literature surrounding the short-term and long-term management of NCCP in patients with psychiatric etiologies or co-morbid psychiatric conditions. Conclusions Though some approaches to the care of patients with NCCP have been developed, more work is needed to determine the most effective management techniques for this unique and high-morbidity population.

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Personality subtypes and chest pain in patients with nonobstructive coronary artery disease from the TweeSteden Mild Stenosis study: mediating effect of anxiety and depression

Abstract: Type D personality, but not negative affectivity or social inhibition, was related to chest pain in nonobstructive CAD, which was mediated by negative mood states.

Cited by 11 publications

References 48 publications

Impaired Health Status, Psychological Distress, and Personality in Women and Men With Nonobstructive Coronary Artery Disease

Impaired Health Status, Psychological Distress, and Personality in Women and Men With Nonobstructive Coronary Artery Disease

Depression and chest pain in patients with coronary artery disease

Non-cardiac Chest Pain: A Review for the Consultation-Liaison Psychiatrist

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