Mourad Ghassan, Strömberg Anna, Johansson Peter, Jaarsma Tiny
Department of Social and Welfare Studies, Linköping University, Kungsgatan 40, 601 74, Norrköping, Sweden.
Departments of Cardiology and Medical and Health Sciences, Linköping University, Linköping, Sweden.
Patient. 2016 Feb;9(1):69-77. doi: 10.1007/s40271-015-0125-0.
Patients with non-cardiac chest pain (NCCP) suffer from recurrent chest pain and make substantial use of healthcare resources.
To explore the prevalence of depressive symptoms, cardiac anxiety, and fear of body sensations in patients discharged with a NCCP diagnosis; and to describe how depressive symptoms, cardiac anxiety, and fear of body sensations are related to each other and to healthcare-seeking behavior.
Cross-sectional design. Data were collected between late October 2013 and early January 2014 in 552 patients with NCCP from four hospitals in southeast Sweden, using the Patient Health Questionnaire-9, Cardiac Anxiety Questionnaire, and Body Sensations Questionnaire.
About 26 % (n = 141) of the study participants reported at least moderate depressive symptoms, 42 % (n = 229) reported at least moderate cardiac anxiety, and 62 % (n = 337) reported some degree of fear of body sensations. We found strong positive relationships between depressive symptoms and cardiac anxiety (r s = 0.49; P < 0.01), depressive symptoms and fear of body sensations (r s = 0.50; P < 0.01), and cardiac anxiety and fear of body sensations (r s = 0.56; P < 0.01). About 60 % of the participants sought care because of chest pain once, 26 % two or three times, and the rest more than three times. In a multivariable regression analysis, and after adjustment for multimorbidity, cardiac anxiety was the only variable independently associated with healthcare-seeking behavior.
Patients with NCCP and many healthcare consultations had high levels of depressive symptoms and cardiac anxiety, and moderate levels of fear of body sensations. Cardiac anxiety had the strongest relationship with healthcare-seeking behavior and may therefore be an important target for intervention to alleviate suffering and to reduce healthcare use and costs.
非心源性胸痛（NCCP）患者反复出现胸痛，并大量使用医疗资源。
探讨诊断为NCCP出院患者中抑郁症状、心脏焦虑和对身体感觉恐惧的患病率；并描述抑郁症状、心脏焦虑和对身体感觉的恐惧之间如何相互关联以及与就医行为的关系。
采用横断面设计。2013年10月下旬至2014年1月初，在瑞典东南部四家医院对552例NCCP患者进行数据收集，使用患者健康问卷-9、心脏焦虑问卷和身体感觉问卷。
约26%（n = 141）的研究参与者报告至少有中度抑郁症状，42%（n = 229）报告至少有中度心脏焦虑，62%（n = 337）报告有一定程度的对身体感觉的恐惧。我们发现抑郁症状与心脏焦虑之间存在强正相关（rs = 0.49；P < 0.01），抑郁症状与对身体感觉的恐惧之间存在强正相关（rs = 0.50；P < 0.01），以及心脏焦虑与对身体感觉的恐惧之间存在强正相关（rs = 0.56；P < 0.01）。约60%的参与者因胸痛就医一次，26%就医两三次，其余就医超过三次。在多变量回归分析中，在调整了多种合并症后，心脏焦虑是唯一与就医行为独立相关的变量。
患有NCCP且多次就医的患者有高水平的抑郁症状和心脏焦虑，以及中度水平的对身体感觉的恐惧。心脏焦虑与就医行为的关系最为密切，因此可能是减轻痛苦、减少医疗使用和成本的重要干预靶点。
