Anxiety disorder in patients with non-specific chest pain in the emergency setting
Anxiety disorder in patients with non-specific chest pain in the emergency setting
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DOI：
10.1136/emj.2005.025163
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发表时间：
2006-02-01
影响因子：
3.1
通讯作者：
Demir, OF
中科院分区：
文献类型：
--
作者：
Demiryoguran, NS;Karcioglu, O;Demir, OF
目的：许多从急诊科（艾德）出院的诊断为“非特异性胸痛"（NSCP）的患者患有焦虑症（AD），这是急性护理中常见的遗漏实体。本研究的目的是描绘的特征属性，可以提高识别AD的艾德患者承认与NSCP。方法：所有患者18岁至65岁之间的诊断与NSCP被招募。采用医院焦虑抑郁量表（HADS）焦虑子量表作为AD的筛选试验。精神科医生对HADS评分较高（>= 10）的患者进行AD评估。结果：共有157名患者入组该研究。49例患者（31.2%）的HADS评分为"高"（>= 10）。HADS评分高的患者出现相关症状的频率更高（p = 0.004）。研究发现，焦虑评分高的患者更常报告头晕或头晕、寒战或潮热以及死亡恐惧。在高分组中，33例（67.3%）患者接受了精神科医生的访谈，其中23例（69.7%）患者被诊断为AD。21例AD患者（91.3%）描述了相关症状。在AD患者中，18例（78.3%）曾因胸痛入住艾德。21例（91.3%）患者描述了非典型胸痛。结论：在排除器质性病因后，医生应始终考虑AD在艾德胸痛患者中的作用。患者对非典型疼痛的定义，艾德的复发，以及相关症状的存在，如头晕，寒战或潮热，以及对死亡的恐惧可能有助于考虑AD。
Objectives: Many patients who have been discharged from the emergency department (ED) with a diagnosis of '' non- specific chest pain '' (NSCP) have anxiety disorder (AD), a commonly missed entity in acute care. The objective of this study was to delineate characteristic properties that could enhance recognition of AD in ED patients admitted with NSCP.Methods: All patients between 18 and 65 years of age diagnosed with NSCP were enrolled. The Hospital Anxiety and Depression Scale ( HADS) anxiety subscale was used as a screening test for AD. The patients with high HADS scores (>= 10) were evaluated by a psychiatrist for AD.Results: In total, 157 patients were enrolled in the study. HADS scores were found to be '' high '' (>= 10) in 49 patients (31.2%). Patients with high HADS scores had a higher frequency of associated symptoms (p = 0.004). Dizziness or lightheadedness, chills or hot flushes, and fear of dying were found to have been reported more frequently by patients with high anxiety scores. Of the group with high score, 33 patients (67.3%) were interviewed by a psychiatrist, and 23 (69.7%) of these patients were diagnosed with AD. Associated symptoms were described by 21 patients with AD (91.3%). Of those with AD, 18 (78.3%) had been previously admitted to the ED with chest pain. Atypical chest pain was described by 21 patients (91.3%).Conclusions: Physicians should always consider AD in patients presenting to the ED with chest pain after ruling out organic aetiology. Patients' definition of atypical pain, recurrent admissions to ED, and presence of associated symptoms such as dizziness, chills or hot flushes, and fear of dying could aid in considering AD.