Non-cardiac, non-oesophageal chest pain: The relevance of psychological factors

Abstract

Background - No cause has been determined for chest pain that is neither cardiac nor oesophageal in origin. Aims - To compare the prevalence of lifetime psychiatric disorders and current psychological distress in three consecutive series of patients with chronic chest or abdominal pain. Patients - Thirty nine patients with noncardiac chest pain and no abnormality on oesophagogastroduodenoscopy, oesophageal manometry, and 24 hour pH monitoring; 22 patients with non-cardiac chest pain having endoscopic abnormality, oesophageal dysmotility, and/or pathological reflux; and 36 patients with biliary colic. Methods - The Diagnostic Interview Schedule and the 28 item General Health Questionnaire were administered to all patients. Results - Patients with non-cardiac chest pain and no upper gastrointestinal disease had a higher proportion of panic disorder (15%), obsessive- compulsive disorder (21%), and major depressive episodes (28%) than patients with gallstone disease (0%, p