Psychiatric morbidity and the presence and absence of angiographic coronary disease in patients with chest pain

Abstract

Objective: To assess psychiatric morbidity in coronary angiogram patients. Method: A psychiatric assessment of 200 consecutive chest‐pain patients was performed the day before coronary angiography in a double‐blind study design. The sample included 132 men (mean age 57.2 years, SD 9.5) and 68 women (mean age 59.8 years, SD 8.9). A Structured Clinical Interview for DSM‐III‐R was used to obtain psychiatric diagnosis. The 21‐item Beck Depression Inventory, the 20‐item Toronto Alexithymia Scale and a four‐item Life Satisfaction Scale were used to assess mental symptoms. A coronary angiography with obstruction of a coronary artery by more than 50% was considered to indicate angiographic coronary disease. Results: Mental disorders were found in 28% (95% CI 14–41) of the patients with normal angiographic findings ( n =47) and in 24% (95% CI 17 – 30) of the patients with angiographic coronary disease ( n =153). Furthermore, no difference was found between these two groups in other rating scales assessing mental symptoms even when adjusted for the New York Heart Association class, duration of chest‐pain symptoms or exercise capacity. Conclusion: Psychiatric morbidity may not be associated with angiographic findings in patients with chest pain.