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. 2016 Oct 18:10:30.
doi: 10.1186/s13030-016-0081-5. eCollection 2016.

Factors associated with pain level in non-cardiac chest pain patients with comorbid panic disorder

Guillaume Foldes-Busque  1 , Stéphanie Hamel  1 , Geneviève Belleville  2 , Richard Fleet  3 , Julien Poitras  4 , Jean-Marc Chauny  5 , Alain Vadeboncoeur  6 , Kim L Lavoie  7 , André Marchand  8
Affiliations

Factors associated with pain level in non-cardiac chest pain patients with comorbid panic disorder

Guillaume Foldes-Busque et al. Biopsychosoc Med. .

Abstract

Background: Panic disorder (PD) is highly prevalent in patients with non-cardiac chest pain (NCCP). This study aims to explore the role of psychological factors (PD intensity, anxiety sensitivity, heart-related fear, attention and avoidance) common to NCCP and PD in predicting chest pain levels in patients with both conditions.

Methods: This association was investigated in emergency department patients with NCCP and PD receiving either evidence-based treatment of PD or treatment as usual. Patients were assessed at baseline and 14 weeks later for post-treatment.

Results: Only heart-focused fear and attention for cardiac sensations independently explained a significant portion of the variance in baseline pain (n = 66). At 3 months follow-up (n = 53), changes in heart-related fear was the only factor independently associated with changes in chest pain intensity. Even in patients with PD, fear specific to cardiac sensations seems to play a central role in determining NCCP intensity.

Conclusion: These results suggest that the efficacy of intervention for patients with PD and comorbid NCCP could be improved by targeting heart-related fear and attention.

Trial registration: NCT00736346.

Keywords: Anxiety sensitivity; Cardiac anxiety; Chest pain; Heart-focused anxiety; Non-cardiac chest pain; Panic disorder.

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