PANIC DISORDER IN CORONARY-ARTERY DISEASE PATIENTS WITH NONCARDIAC CHEST PAIN

In this study we address the following questions: (1) What percentage of coronary artery disease (CAD) patients that present with chest pain , but whose symptoms cannot be fully explained by their cardiac status , suffer from panic disorder (PD)? (2) How do patients with both CAD a nd PD compare to patients without CAD and to patients without either P D or CAD in terms of psychological distress? Four hundred forty-one co nsecutive walk-in emergency department patients with chest pain underw ent a structured psychiatric interview (ADIS-R) and completed psycholo gical scales. Fifty-seven percent (250 of 441) of these patients were diagnosed as having noncardiac chest pain and constituted this study's sample, A total of 30% (74 of 250) of noncardiac chest pain patients had a documented history of CAD. Thirty-four percent (25 of 74) of CAD patients met criteria for PD. Patients with both PD and CAD displayed significantly more psychological distress than CAD patients without P D and patients with neither CAD nor PD. However, they did not differ f rom non-CAD patients with PD. PD is highly prevalent in patients with CAD that are discharged with noncardiac diagnoses. The psychological d istress in these patients appears to be related to the panic syndrome and not to the presence of the cardiac condition. (C) 1998 Elsevier Sc ience Inc.