Two-year follow-up status of emergency department patients with chest pain: Was it panic disorder?

Autor:	André Marchand, Jean-Pierre Martel, Kim L. Lavoie, Gilles Dupuis, Bernard D. Beitman, Richard P. Fleet
Rok vydání:	2003
Předmět:	medicine.medical_specialty business.industry Panic disorder Panic symptoms Emergency department medicine.disease Chest pain Internal medicine Emergency Medicine medicine medicine.symptom business Psychiatry Follow up status Psychosocial Suicidal ideation Depression (differential diagnoses)
Zdroj:	CJEM. 5:247-254
ISSN:	1481-8043 1481-8035
Popis:	Objectives: We previously reported that 25% (108/441) of consecutive patients presenting to the emergency department (ED) of the Montreal Heart Institute with a chief complaint of chest pain suffered from panic disorder (PD). The purpose of the present study was to re-examine these patients (with and without PD) 2 years after their initial ED visit to determine their psychiatric and psychosocial status. Methods: An interviewer, who was kept blind to patients’ initial medical and psychiatric diagnoses, attempted to contact all patients who participated in the initial study by phone. Patients who completed the phone interview were sent a battery of psychological questionnaires by mail. Results: A total of 301 (70%) patients completed the phone interview, and 228 (52%) patients completed the self-report questionnaires. Participants and non-participants did not differ with respect to age, gender, initial self-report scores, or initial cardiac or psychiatric diagnoses. At follow-up, significantly (p < 0.05) more PD+ than non-PD (PD–) patients reported: 1) chest pains in the last month (57% vs. 31%); 2) one or more ED consultations in the past year for chest pain (40% vs. 14%); 3) one or more hospitalizations in the past year (31% vs. 11%); and 4) perceiving their general health as “poor” (22% vs. 9%). PD+ patients displayed a significant (p < 0.05) worsening of their panic symptoms, agoraphobic avoidance, depression, and trait anxiety, and reported significantly (p < 0.05) greater suicidal ideation compared to PD– patients (32% vs. 9%). Of all PD+ patients, only 22% (18/82) reported receiving some form of mental health treatment for their symptoms. Conclusions: Unrecognized and untreated PD has a chronic and disabling course. Greater efforts should be made to screen for PD in patients complaining of chest pain in EDs.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6b94bcff32a40b96a8fbfcf8609179bd https://doi.org/10.1017/s1481803500008447 Zobrazit plný text záznamu