Korean J Pain.  2021 Oct;34(4):417-426. 10.3344/kjp.2021.34.4.417.

Determinants of depression in non-cardiac chest pain patients: a cross sectional study

Affiliations
  • 1Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  • 2Students’ Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  • 3Department of Biostatistics and Epidemiology, School of Health and Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  • 4Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background
Non-cardiac chest pain (NCCP) is a common patient complaint imposing great costs on the healthcare system. It is associated with psychological factors such as depression. The aim of the present study is determining depression predictors in NCCP patients.
Methods
The participants of this cross-sectional study were 361 NCCP patients. Patients filled out questionnaires concerning their sociodemographic, lifestyle, and clinical factors (severity of pain, type D personality, somatization, cardiac anxiety, fear of body sensations, and depression).
Results
Based on multiple ordinal logistic regression, lack of physical activity (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.09-2.87), sleep quality (OR, 2.98; 95% CI, 1.15-7.69), being a smoker (OR, 1.33; 95% CI, 2.41-4.03), present pain intensity (OR, 1.08; 95% CI, 1.05-1.11), type D personality (OR, 2.43; 95% CI, 1.47- 4.03), and somatization (OR, 1.22; 95% CI, 1.15-1.3) were significant predictors of depression in NCCP patients. Additionally, multiple linear regression showed that being unmarried (β = 1.51, P = 0.008), lack of physical activity (β = 1.22, P = 0.015), sleep quality (β = 2.26, P = 0.022), present pain intensity (β = 0.07, P = 0.045), type D personality (β = 1.87, P < 0.001), somatization (β = 0.45, P < 0.001), and fear of bodily sensation (β = 0.04, P = 0.032) increased significantly depression scores in NCCP patients.
Conclusions
Physicians should consider the predictors of depression in NCCP patients which can lead to receiving effective psychological consultations and reducing the costs and ineffectual referrals to medical centers.

Keyword

Anxiety; Chest Pain; Cross-Sectional Studies; Depression; Life Style; Psychology; Somatoform Disorders; Type D Personality
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