Patients with noncardiac chest pain and benign palpitations referred for cardiac outpatient investigation: a 6-month follow-up

Jonsbu, Egil; Dammen, Toril; Morken, Gunnar; Martinsen, Egil W.

doi:10.1016/j.genhosppsych.2010.03.003

« Previous Next »General Hospital Psychiatry
Volume 32, Issue 4 , Pages 406-412, July 2010

Patients with noncardiac chest pain and benign palpitations referred for cardiac outpatient investigation: a 6-month follow-up☆

Egil Jonsbu, M.D.
- Department of Psychiatry, Molde Hospital, 6407 Molde, Norway
- Department of Neuroscience, Norwegian University of Science and Technology, 7491 Trondheim, Norway
- Corresponding author. Department of Psychiatry, Molde Hospital, 6407 Molde, Norway. Tel.: +47 71122900; fax: +47 71122902.
Toril Dammen, M.D., Ph.D.
- Institute of Basic Medical Sciences, Department of Behavioural Sciences in Medicine, Faculty of Medicine, University of Oslo, 0317 Oslo, Norway
- Oslo University Hospital Ullevaal, Department of Psychiatry, 0407 Oslo, Norway
Gunnar Morken, M.D., Ph.D.
- Department of Neuroscience, Norwegian University of Science and Technology, 7491 Trondheim, Norway
- Østmarka Department of Psychiatry, St Olavs University Hospital, Trondheim Norway
Egil W. Martinsen, M.D., Ph.D.
- Institute of Psychiatry, University of Oslo, 0318 Oslo, Norway
- Oslo University Hospital, Aker, 0514 Oslo, Norway

Received 22 December 2009; accepted 9 March 2010. published online 14 April 2010.

Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords: Chest pain, Palpitations, Follow-up, Interest in treatment