Non-Cardiac Chest Pain as a Persistent Physical Symptom: Psychological Distress and Workability

Sigrún Ólafsdóttir Flóvenz (), Paul Salkovskis, Erla Svansdóttir, Hróbjartur Darri Karlsson, Karl Andersen and Jón Friðrik Sigurðsson
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Sigrún Ólafsdóttir Flóvenz: Department of Psychology, Reykjavik University, 101 Reykjavik, Iceland
Paul Salkovskis: Oxford Centre for Psychological Health, Oxford Institute of Clinical Psychology Training and Research Oxford Cognitive Therapy Centre, Warneford Hospital, Oxford University, Oxford OX3 7JX, UK
Erla Svansdóttir: The National Hospital of Iceland, 101 Reykjavik, Iceland
Hróbjartur Darri Karlsson: Spitalzentrum Biel, 2501 Biel, Switzerland
Karl Andersen: The National Hospital of Iceland, 101 Reykjavik, Iceland
Jón Friðrik Sigurðsson: Department of Psychology, Reykjavik University, 101 Reykjavik, Iceland

IJERPH, 2023, vol. 20, issue 3, 1-10

Abstract: Non-Cardiac Chest Pain (NCCP) is persistent chest pain in the absence of identifiable cardiac pathology. Some NCCP cases meet criteria for Persistent Physical Symptoms (PPS), where the symptoms are both persistent and distressing/disabling. This study aimed to identify patients that might need specialist treatment for PPS by examining cases of NCCP that meet PPS criteria. We analysed data from 285 chest pain patients that had received an NCCP diagnosis after attending an emergency cardiac department. We compared NCCP patients who did and did not meet the additional criteria for heart-related PPS and hypothesised that the groups would differ in terms of psychological variables and workability. We determined that NCCP patients who meet PPS criteria were more likely than other NCCP patients to be inactive or unable to work, reported more general anxiety and anxiety about their health, were more depressed, ruminated more, and, importantly, had a higher number of other PPS. A high proportion of NCCP patients meet PPS criteria, and they are similar to other PPS patients in terms of comorbidity and disability. This highlights the importance of focusing psychological interventions for this subgroup on the interplay between the range of physical and psychological symptoms present.

Keywords: PPS (Persistent Physical Symptoms); non-cardiac chest pain; NCCP; workability; medically unexplained symptoms; MUS (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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