GERD-unrelated Non-cardiac Chest Pain may be Associated with Depression and Anxiety

위식도역류질환과 관련 없는 비심인성 흉통 환자의 우울 및 불안

  • Park, Joo-Eon (Department of Psychiatry, Incheon Christian Hospital) ;
  • Ryu, Han-Wook (Hae-Su Child & Adolescent Psychiatric Clinic) ;
  • Rhee, Poong-Lyul (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yu, Bum-Hee (Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 박주언 (인천기독병원 정신과) ;
  • 류한욱 (해수 소아청소년 정신과) ;
  • 이풍렬 (성균관대학교 의과대학 삼성서울병원 내과학교실) ;
  • 유범희 (성균관대학교 의과대학 삼성서울병원 정신과학교실)
  • Received : 2006.04.28
  • Accepted : 2006.05.11
  • Published : 2006.06.30

Abstract

Objectives : Non-cardiac chest pain (NCCP) can be divided into gastroesophageal reflux disease (GERD) related NCCP and non-GERD related NCCP. Our study was designed to examine the differences in clinical characteristics and psychological mood states between the two clinical syndromes. Methods : After some cardiologic evaluations such as treadmill exercise, coronary angiography, and echocardiography, 27 patients with NCCP were enrolled in this study. They were divided into patients with GERD related NCCP (12 patients) and those with non-GERD related NCCP (15 patients) using the upper gastrointestinal endoscopy and the ambulatory 24 hour esophageal pH monitoring. Clinical characteristics such as typical reflux symptoms and psychological mood states were measured. Patients who showed scores more than 10 on the Beck Depression Inventory (BDI) or Beck Anxiety Inventory (BAI) were defined as depressed or anxious group. Anxiety sensitivity Index (ASI) was also measured in all patients. All parameters were compared between patients with GERD related NCCP and those with non-GERD related NCCP. Results : The two groups showed a difference in typical reflux symptoms. Patients with non-GERD related NCCP had higher scores on the BDI, BAI and ASI than those with GERD related NCCP. Among all NCCP patients, 14 patients (51.9%) were suggested to have possible depression or anxiety disorders. Conclusion : The non-GERD related NCCP was shown to be associated with psychological mood states such as anxiety and depression. Thus, we suggest that routine measurement of psychological mood states should be necessary in the evaluation and treatment of NCCP.

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