Prevalence of Psychiatric Disorders in Patients with Chest Pain Complaints Referred to the Heart Emergency Department of Taleghani Hospital in Tehran, Iran
Background: Chest pain is one of the most common reasons for people to go to cardiac emergency clinics. This study was conducted with the aim to evaluate the prevalence of psychiatric disorders in patients with chest pain referred to the heart emergency clinic of Taleghani Hospital, Tehran, Iran.
Methods: This descriptive-analytic study was performed on 103 patients with chest pain who were referred to the emergency department. Furthermore, a follow-up was carried out. Data were collected using a demographic information form and mental health survey (28-item General Health Questionnaire; Goldberg & Hillier, 1979) in the two groups of cardiac and non-cardiac chest pain.
Results: Among all the referred patients, 74 patients (71.8%) did not have a definitive diagnosis of cardiovascular disorders (CVDs). The results revealed that among the patients with non-cardiac chest pain, 56 (75.7%), 55 (74.3%), 54 (73%), and 22 (29.7%) individuals had phyisical disorder, anxiety, social dysfunction, and depressive disorder. Among the patients, who were definitively diagnosed with CVDs, 14 (48.3%), 10 (34.5%), 7 (24.1%), and 6 (20.7%) individuals had anxiety, physical disoreder, social dysfunction, and depressive disorder. Among all patients, physical disorder had a significant relationship with gender (P = 0.047), and physical and anxiety disorders had a significant relationship with history of recurrent chest pain in the last 6 months (P < 0.05).
Conclusion: Due to the high number of non-cardiac patients who refer to the emergency department with chest pain complaints, it is recommended that all patients with chest pain complaints be screened for psychiatric diseases.
Alkhadhari, S., Alsabrrie, A. O., Ohaeri, J. U., Varghese, R., Zahid, M. A., & Mulsant, B. H. (2018). Mental and physical comorbidity in an Arab primary health care setting. BMC.Psychiatry, 18(1), 313. doi:10.1186/s12888-018-1903-8 [doi];10.1186/s12888-018-1903-8 [pii]. Retrieved from PM:30261859
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: Dsm-5. Arlington, VA: American Psychiatric Publications.
Beheshti, A., Irajian, G., Darabian, M., Shafaeian, M., Ghorbani, R., Keshavarzian, M. et al. (2006). Determination of frequency and intensity of psychical disorders in patients with chest pain with non-cardiac origin referred to cardiovascular clinics (2004-2005). Koomesh, 7(1), 101-106.
Castillo-Richmond, A., Schneider, R. H., Alexander, C. N., Cook, R., Myers, H., Nidich, S. et al. (2000). Effects of stress reduction on carotid atherosclerosis in hypertensive African Americans. Stroke., 31(3), 568-573. doi:10.1161/01.str.31.3.568 [doi]. Retrieved from PM:10700487
Frasure-Smith, N., & Lesperance, F. (2005). Reflections on depression as a cardiac risk factor. Psychosom.Med, 67 Suppl 1 , S19-S25. doi:67/Supplement_1/S19 [pii];10.1097/01.psy.0000162253.07959.db [doi]. Retrieved from PM:15953794
GHDx. (2017). Global Burden of Disease Study (GBD 2017) Data Resources [Online]. Available from: URL: http://ghdx.healthdata.org/gbd-2017 (Accessed 2021).
Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychol Med, 9(1), 139-145. doi:10.1017/s0033291700021644 [doi]. Retrieved from PM:424481
Hajebi, A., Motevalian, S. A., Rahimi-Movaghar, A., Sharifi, V., Amin-Esmaeili, M., Radgoodarzi, R. et al. (2018). Major anxiety disorders in Iran: prevalence, sociodemographic correlates and service utilization. BMC.Psychiatry, 18(1), 261. doi:10.1186/s12888-018-1828-2 [doi];10.1186/s12888-018-1828-2 [pii]. Retrieved from PM:30126386
Haug, T. T., Mykletun, A., & Dahl, A. A. (2004). The association between anxiety, depression, and somatic symptoms in a large population: the HUNT-II study. Psychosom.Med, 66(6), 845-851. doi:66/6/845 [pii];10.1097/01.psy.0000145823.85658.0c [doi]. Retrieved from PM:15564348
Knockaert, D., Buntinx, F., Stoens, N., Bruyninckx, R., & Delooz, H. (2002). Chest pain in the emergency department: the broad spectrum of causes. Eur J Emerg Med, 9(1), 25-30. Retrieved from PM: 11989492.
Kasper, D. L., Fauci, A. S., Hauser, S. L., Longo, D. L., Jameson, J. L., & Loscalzo, J. (2015). Harrison's Principles of Internal Medicine (19th ed.). New York, NY: McGraw-Hill Education.
Katon, W., Hall, M. L., Russo, J., Cormier, L., Hollifield, M., Vitaliano, P. P. et al. (1988). Chest pain: Relationship of psychiatric illness to coronary arteriographic results. Am.J.Med., 84(1), 1-9.
Kuijpers, P. M., Honig, A., Griez, E. J., Braat, S. H., & Wellens, H. J. (2000). [Panic disorder, chest pain and palpitations: a pilot study of a Dutch First Heart Aid]. Ned.Tijdschr.Geneeskd., 144(16), 745-749. Retrieved from PM:10812442
Maghsoodi, S., Hesabi, M., Emami sigaroudi, A., Kazemnejad leili, E., & Monfared, A. (2015). General health and related factors in employed nurses in Medical-Educational Centers in Rasht. Holist Nurs Midwifery, 25(1), 63-72.
Mayou, R., Bass, C. M., & Sharpe, M. (1995). Treatment of functional somatic symptoms. Oxford, UK: Oxford University Press.
Mayou, R. A., Gill, D., Thompson, D. R., Day, A., Hicks, N., Volmink, J. et al. (2000). Depression and anxiety as predictors of outcome after myocardial infarction. Psychosom.Med, 62(2), 212-219. doi:10.1097/00006842-200003000-00011 [doi]. Retrieved from PM:10772399
Mohamadi, M., Mohaqeqi Kamal, S. H., Vameghi, M., Rafiey, H., Setareh Forouzan, A. & Sajjadi, H. (2017). A meta-analysis of studies related prevalence of depression in Iran. J Research Health, 7, 581-593.
Motaghipour, Y., Valaei, F., Amiri, P., Emami, H., Mohammad Beygi, F., Hajipour, R. et al. (2006). Study of the general mental health status in an area of Tehran: Tehran Lipid and Glucose Study (TLGS). Iran J Endocrinol Metab, 7(4), 301-306.
Noorbala, A. A., Bagheri Yazdi, S. A., Faghihzadeh, S., Kamali, K., Faghihzadeh, E., Hajebi, A. et al. (2017a). A survey on mental health status of adult population aged 15 and above in the province of Razavi Khorasan, Iran. Arch Iran Med, 20(11 Suppl. 1), S99-S102. Retrieved from PM:29481140
Noorbala, A. A., Bagheri Yazdi, S. A., Faghihzadeh, S., Kamali, K., Faghihzadeh, E., Hajebi, A. et al. (2017b). A Survey on Mental Health Status of Adult Population Aged 15 and above in the Province of Ardebil, Iran. Arch Iran Med, 20(11 Suppl. 1), S11-S14. Retrieved from PM:29481118
Noorbala, A. A., Bagheri Yazdi, S. A., Asadi Lari, M., & Vaez Mahdavi, M. R. (2011). Mental health status of individuals fifteen years and older in Tehran-Iran (2009). Iran J Psychiatry Clin Psychol, 16(4), 479-483.
Nourbala, A. A., Bagheri Yazdi, S. A., & Mohammad, K. (2009). The validation of General Health Questionnaire- 28 as a psychiatric screening Tool. Hakim Res J 11(4), 47-53.
Olfson, M., Marcus, S. C., Druss, B., Elinson, L., Tanielian, T., & Pincus, H. A. (2002). National trends in the outpatient treatment of depression. JAMA., 287(2), 203-209. doi:joc11356 [pii];10.1001/jama.287.2.203 [doi]. Retrieved from PM:11779262
Safa, M., Saki, M., & Matin-Rohani, S. (2008). Study of mental health of the patients who need coronary angiography and its relationship with drug abuse. Yafteh, 10(1), 47-53.
Salehi Omran, M. T., & Asna ashari, M. (2017). Evaluation of Coronary Artery Disease in Patients with Atypical Chest Pain Based on Exercise Test. J Babol Univ Med Sci, 19(1), 43-47.
Sharifi, V., Amin-Esmaeili, M., Hajebi, A., Motevalian, A., Radgoodarzi, R., Hefazi, M., & Rahimi-Movaghar, A. (2015). Twelve-month prevalence and correlates of psychiatric disorders in Iran: The Iranian Mental Health Survey, 2011. Arch Iran Med, 18(2), 76-84. Retrieved from PM: 25644794
Stewart, M., Davidson, K., Meade, D., Hirth, A., & Makrides, L. (2000). Myocardial infarction: survivors' and spouses' stress, coping, and support. J Adv.Nurs, 31(6), 1351-1360. doi:jan1454 [pii];10.1046/j.1365-2648.2000.01454.x [doi]. Retrieved from PM:10849146
Taylor, R. B. (2002). Manual of family practice (vol. 43). Philadelphia, PA: Lippincott Williams & Wilkins.
Wool, C. A., & Barsky, A. J. (1994). Do women somatize more than men? Gender differences in somatization. Psychosomatics., 35(5), 445-452. doi:S0033-3182(94)71738-2 [pii];10.1016/S0033-3182(94)71738-2 [doi]. Retrieved from PM:7972659
World Bank. (2007). Islamic Republic of Iran health sector review. Washington, DC; World Bank.
World Health Organization. (2008). WHO report on the global tobacco epidemic 2008. Geneva, Switzerland: WHO.
Zipes, D. P., Libby, P., Braunwald, E., Bonow, R. O., Mann, D. L., & Tomaselli, G. F. (2019). Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. Philadelphia, PA: Elsevier/Saunders.
How to Cite
Copyright (c) 2020 Farzad Goli, Saeed Ganji, Hamid Afshar Zanjani, Amir Ghaffari Jolfayi, Parastoo Amiri, Azadeh Sayarifard, Fakhri alsadat Khalifeh Soltani, Maryam Mohseny
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.