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. 2020 Mar 12;18(1):68.
doi: 10.1186/s12955-020-01297-0.

The associations between psychological distress and health-related quality of life in patients with non-cardiac chest pain

Ghassan Mourad  1 , Jenny Alwin  2 , Tiny Jaarsma  2 , Anna Strömberg  2   3 , Peter Johansson  2
Affiliations

The associations between psychological distress and health-related quality of life in patients with non-cardiac chest pain

Ghassan Mourad et al. Health Qual Life Outcomes. .

Abstract

Background: Recurrent chest pain episodes with no clear explanation may affect patients' psychological wellbeing and health-related quality of life (HRQoL) negatively. Despite the fact that a significant amount of patients with non-cardiac chest pain (NCCP) might have a history of Cardiac Disease (CD), there is today a lack of knowledge on how CD influences the association between psychological wellbeing and HRQoL in patients with NCCP. Therefore, the aim of this study is to describe HRQoL in patients with NCCP, with or without history of CD, and to explore the association between HRQoL and cardiac anxiety, depressive symptoms, fear of body sensations and somatization.

Methods: Five hundred fifty-two patients discharged with NCCP from four hospitals in Southeast Sweden completed the EQ-5D, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9, Body Sensations Questionnaire, and Patient Health Questionnaire-15.

Results: Fifty precent reported at least moderate problems regarding pain/discomfort and 25% reported at least moderate problems in the HRQoL dimensions mobility, usual activities, and anxiety/depression. Patients with NCCP and history of CD reported significantly lower HRQoL (p ≤ 0.05) compared to patients with NCCP without CD. In the total study population, cardiac anxiety, depressive symptoms, and somatization had weak significant negative associations (beta = 0.187-0.284, p < 0.001) with HRQoL. In patients with history of CD, the association between depressive symptoms and HRQoL was moderate (beta = - 0.339, p < 0.001), compared to weak association in patients without CD (beta = - 0.193, p < 0.001). On the other hand, the association between cardiac anxiety and HRQoL was weak in both patients with history of CD (beta = - 0.156, p = 0.05), and in those without (beta = - 0.229, p < 0.001).

Conclusions: Patients with NCCP, in particular those with history of CD, reported low levels of HRQoL, which was associated with psychological distress. This should be considered when developing psychological interventions aiming to improve HRQoL in patients with NCCP.

Keywords: Cardiac disease; EQ-5D-5 L; HRQoL; Non-cardiac chest pain; Psychological distress.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
EQ-5D in all patients with non-cardiac chest pain (NCCP) (N = 552), and in NCCP without (n = 360) or NCCP with (n = 188) history of cardiac disease (CD). * = p < 0.05, ** = p < 0.01, *** = p < 0.001 regarding differences between the two groups
See this image and copyright information in PMC

References

    1. Glombiewski JA, et al. The course of nonspecific chest pain in primary care: symptom persistence and health care usage. Arch Intern Med. 2010;170(3):251–255. doi: 10.1001/archinternmed.2009.474. - DOI - PubMed
    1. Leise MD, et al. Patients dismissed from the hospital with a diagnosis of noncardiac chest pain: cardiac outcomes and health care utilization. Mayo Clinic Proceedings Mayo Clinic. 2010;85(4):323–330. doi: 10.4065/mcp.2009.0428. - DOI - PMC - PubMed
    1. Eslick GD. Health care seeking behaviors, psychological factors, and quality of life of noncardiac chest pain. Disease-a-month : DM. 2008;54(9):604–612. doi: 10.1016/j.disamonth.2008.06.004. - DOI - PubMed
    1. Dumville JC, et al. Non-cardiac chest pain: a retrospective cohort study of patients who attended a rapid access chest pain clinic. Fam Pract. 2007;24(2):152–157. doi: 10.1093/fampra/cmm002. - DOI - PubMed
    1. Mol KA, et al. Non-cardiac chest pain: prognosis and secondary healthcare utilisation. Open Heart. 2018;5(2):e000859. doi: 10.1136/openhrt-2018-000859. - DOI - PMC - PubMed