A behavioral study of middle-aged chest pain patients: Physical symptom reporting, anxiety, and depression

Abstract

Three groups of patients (32 to 72 years of age), admitted for cinearteriography, were tested approximately 24 hours before the procedure. Measures of symptom self-reporting, anxiety, depression, and neuroticism were employed. The major group of interest had no prior history of myocardial infarction and other forms of heart disease, but was scheduled for cinearteriography because of anginal pain and other indications of angina pectoris. Based on the results of arteriographic studies (available after behavioral testing was complete) this group was divided into two major groups of interest: one with clinically significant coronary artery disease and one with angina pectoris syndrome but no clinically significant coronary artery disease. A third group had experienced one or more infarctions and had been diagnosed as cardiovascularly diseased prior to behavioral testing. Anxiety, depression, and symptoms reported were significantly higher for the subjects who experienced angina-like pain but were found to be free from significant coronary artery disease when compared with the other groups. The group with significant CAD and the MI group (also with CAD) did not differ significantly for any dependent variable. Degree of stenosis was negatively correlated with number of symptoms reported, trait anxiety, and depression, and positively correlated with age. None of the relationships among CAD status and the psychological and symptom report measures were diminished by partialling out age statistically; in fact, several were enhanced. Only a few specific kinds of physical symptoms were correlated (positively) with age; many were correlated (negatively) with CAD status. Our data were consistent with predictions based on the work by Costa, et al. reported in this journal.