Anxiety disorders in patients with noncardiac chest pain: association with health-related quality of life and chest pain severity

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Abstract

Background

Patients with noncardiac chest pain (NCCP) report more severe symptoms and lowered health-related quality of life when they present with comorbid panic disorder (PD). Although generalized anxiety disorder (GAD) is the second most common psychiatric disorder in these patients, its impact on NCCP and health-related quality of life remains understudied. This study describes and prospectively compares patients with NCCP with or without PD or GAD in terms of (1) NCCP severity; and (2) the physical and mental components of health-related quality of life.

Methods

A total of 915 patients with NCCP were consecutively recruited in two emergency departments. The presence of comorbid PD or GAD was assessed at baseline with the Anxiety Disorder Schedule for DSM-IV. NCCP severity at baseline and at the six-month follow-up was assessed with a structured telephone interview, and the patients completed the 12-item Short-Form Health Survey Version 2 (SF-12v2) to assess health-related quality of life at both time points.

Results

Average NCCP severity decreased between baseline and the six-month follow-up ( p < .001) and was higher in the patients with comorbid PD or GAD ( p < .001) at both time points compared to those with NCCP only. However, average NCCP severity did not differ between patients with PD and those with GAD ( p = 0.901). The physical component of quality of life improved over time ( p = 0.016) and was significantly lower in the subset of patients with PD with or without comorbid GAD compared to the other groups ( p < .001). A significant time x group interaction was found for the mental component of quality of life ( p = 0.0499). GAD with or without comorbid PD was associated with a lower mental quality of life, and this effect increased at the six-month follow-up.

Conclusions

Comorbid PD or GAD are prospectively associated with increased chest pain severity and lowered health-related quality of life in patients with NCCP. PD appears to be mainly associated with the physical component of quality of life, while GAD has a greater association with the mental component. Knowledge of these differences could help in the management of patients with NCCP and these comorbidities.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-021-01912-8.

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Most cited references 60

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Author and article information

Contributors

Stéphanie Hamel: stephanie.hamel.3@ulaval.ca

Isabelle Denis: isabelle.denis@psy.ulaval.ca

Stéphane Turcotte: stephane_turcotte@ssss.gouv.qc.ca

Richard Fleet: richard.fleet@fmed.ulaval.ca

Patrick Archambault: patrick.m.archambault@gmail.com

Clermont E. Dionne: clermont.dionne@crchudequebec.ulaval.ca

Guillaume Foldes-Busque:

ORCID: http://orcid.org/0000-0003-1179-4187

guillaume.foldes-busque@psy.ulaval.ca

Journal

Journal ID (nlm-ta): Health Qual Life Outcomes

Journal ID (iso-abbrev): Health Qual Life Outcomes

Title: Health and Quality of Life Outcomes

Publisher: BioMed Central (London )

ISSN (Electronic): 1477-7525

Publication date (Electronic): 10 January 2022

Publication date PMC-release: 10 January 2022

Publication date Collection: 2022

Volume: 20

Electronic Location Identifier: 7

Affiliations

[1 ]GRID grid.23856.3a, ISNI 0000 0004 1936 8390, School of Psychology, , Université Laval, Pavillon Félix-Antoine-Savard, ; 2325 rue des Bibliothèques, Quebec, QC G1V 0A6 Canada

[2 ]GRID grid.420763.4, ISNI 0000 0004 4686 6563, Research Centre of the Centre Hospitalier Affilié Universitaire de Lévis of the Centre Intégré de Santé Et de Services Sociaux de Chaudière-Appalaches, ; 143 Rue Wolfe, Lévis, QC G6V 3Z1 Canada

[3 ]Centre de Recherche Universitaire Sur Les Jeunes Et Les Familles (CRUJeF), 2915 avenue du Bourg-Royal, Quebec, QC G1C 3S2 Canada

[4 ]GRID grid.23856.3a, ISNI 0000 0004 1936 8390, Department of Family and Emergency Medicine, , Université Laval, Pavillon Ferdinand-Vandry, ; 1050 Avenue de la Médecine, Quebec, QC G1V 0A6 Canada

[5 ]GRID grid.416673.1, ISNI 0000 0004 0457 3535, CHU de Quebec Research Centre, , Saint-Sacrement Hospital, ; 1050, Chemin Sainte-Foy, Quebec, QC G1S 4L8 Canada

[6 ]GRID grid.23856.3a, ISNI 0000 0004 1936 8390, Quebec Heart and Lung Institute Research Centre, ; 2725 chemin Sainte-Foy, Quebec, QC G1V 4G5 Canada

Author information

Guillaume Foldes-Busque http://orcid.org/0000-0003-1179-4187

Article

Publisher ID: 1912

DOI: 10.1186/s12955-021-01912-8

PMC ID: 8751105

PubMed ID: 35012545

SO-VID: 9e75cc87-1d6c-4e5f-9352-4ac3e9dd7777

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 25 August 2021

Date accepted : 21 December 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;

Award ID: 245714

Award ID: 301157

Award Recipient : Stéphanie Hamel

Funded by: FundRef http://dx.doi.org/10.13039/501100000156, Fonds de Recherche du Québec - Santé;

Award ID: 29533

Award ID: 28882

Award ID: 266918

Award Recipient : Stéphanie Hamel Guillaume Foldes-Busque

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: anxiety,chest pain severity,generalized anxiety disorder,noncardiac chest pain,panic disorder,quality of life

Data availability:

ScienceOpen disciplines: Health & Social care

Keywords: anxiety, chest pain severity, generalized anxiety disorder, noncardiac chest pain, panic disorder, quality of life

Anxiety disorders in patients with noncardiac chest pain: association with health-related quality of life and chest pain severity

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Abstract

Background

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Supplementary Information

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Most cited references 60

Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis.

Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment.

Reliability and validity of the SF-12v2 in the medical expenditure panel survey.

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