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Psychological morbidity in patients with chest pain and normal or near-normal coronary arteries: a long-term follow-up study

Published online by Cambridge University Press:  09 July 2009

S. G. Potts  and
C. M. Bass
S. G. Potts*
Affiliation:
Department of Psychological Medicine, King's College Hospital, London
C. M. Bass
Affiliation:
Department of Psychological Medicine, King's College Hospital, London
*
1Address for Correspondence. Dr S. G. Potts, University Department of Psychiatry, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5ED.
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Synopsis

Forty-six patients with chest pain but normal or near-normal coronary arteries were assessed using standardized interviews and rating scales at the time of angiography, after 1 year, and again 11·4 years later. Psychological morbidity was substantial and enduring: 61% of patients were designated as psychiatric cases at angiography and 49% at 11·4 years. Both at the time of angiography, and 1 year later, levels of morbidity were significantly greater than in a control group of 53 patients with coronary artery disease. Anxiety disorders were common at all three interviews, with panic disorder (15% of patients) the most common current diagnosis at final follow-up. Current somatoform disorders were diagnosed in 9 patients (22%), and 11 (27 %) reported previous episodes of major depression. Psychological morbidity was associated with continuing chest pain, which was reported in 74% of patients, and with ongoing functional incapacity. These findings suggest that, in a sub-group of these patients, psychological factors contribute in part to the development of chest pain and other physical symptoms, and are also important in maintaining the disorder over long periods. Further research is now required to identify more fully the nature of these psychological factors, and how they interact with cardiac and non-cardiac physical pathology. There is also an urgent need to examine the clinical and economic benefits of specific psychological interventions.

Type
Original Articles
Information
Psychological Medicine , Volume 25 , Issue 2 , March 1995 , pp. 339 - 347
Copyright
Copyright © Cambridge University Press 1995

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