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

Funding Information: The authors thank the Graduate Program in Agricultural Engineering of the Federal University of Campina Grande, the National Council for Scientific and Technological Development (CNPq), and the Coordination for the Improvement of Higher Education Personnel (CAPES) for the financial support in carrying out this research. Funding Information: The larger study, which this study is part of, was supported by Icelandic Research Fund under Grant 152207-051 and the University Hospital Science Fund under Grant A-2019-023, A-2018-047 and A-2017-051. Publisher Copyright: © 2023 by the authors.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.Peer reviewe