Department of Psychiatry, Molde Hospital, 6407 Molde, Norway.
Gen Hosp Psychiatry. 2010 Jul-Aug;32(4):406-12. doi: 10.1016/j.genhosppsych.2010.03.003. Epub 2010 Apr 13.
The aims were to (a) study the characteristics and outcome in patients with noncardiac chest pain or benign palpitations referred for cardiac evaluation, (b) compare psychological characteristics in the two groups, (c) identify predictors of outcome (d) and explore characteristics of patients who wanted psychological treatment.
The patients (N=154) were first evaluated by a psychiatrist and than by a cardiologist at the initial attendance and by self report after 6 months.
Thirty nine percent had at least one DSM-IV psychiatric disorder at attendance. At the 6-month follow-up, 43% still had clinically significant complaints and/or impaired function. Patients with palpitations were more likely to be female, younger and less likely to attribute cardiac symptoms to heart disease, but had otherwise similar psychological features to noncardiac chest pain patients. Depression score at attendance predicted significant complaints at follow-up. Interest in psychological treatment was associated with more fear of bodily sensations, more impaired function, and greater tendency to attribute symptoms to heart disease.
Psychiatric disorders were common. The 6-month outcome was poor and was associated with the depression score at attendance. Patients with fear of bodily symptoms and impaired function were most interested in psychological treatment.
（a）研究因非心源性胸痛或良性心悸而接受心脏评估的患者的特征和结局；（b）比较两组的心理特征；（c）确定预后的预测因素；（d）探讨希望接受心理治疗的患者的特征。
患者（N=154）首先由精神科医生和心脏病专家在初次就诊时进行评估，然后在 6 个月后通过自我报告进行评估。
39%的患者在就诊时至少有一种 DSM-IV 精神障碍。在 6 个月的随访中，43%的患者仍有临床显著的抱怨和/或功能受损。心悸患者更可能是女性、年轻，且不太可能将心脏症状归因于心脏病，但与非心源性胸痛患者具有相似的心理特征。就诊时的抑郁评分预测随访时的显著抱怨。对心理治疗的兴趣与更多的躯体感觉恐惧、更多的功能受损以及更大的将症状归因于心脏病的倾向相关。
精神障碍很常见。6 个月的预后较差，与就诊时的抑郁评分有关。对躯体症状恐惧和功能受损的患者最希望接受心理治疗。
