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Ronnie Fass - One of the best experts on this subject based on the ideXlab platform.
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Noncardiac Chest Pain: diagnosis and management.
Current opinion in gastroenterology, 2017Co-Authors: Takahisa Yamasaki, Ronnie FassAbstract:Noncardiac Chest Pain (NCCP) has been defined as recurrent Chest Pain that is indistinguishable from ischemic heart Pain after excluding a cardiac cause. NCCP is a common and highly challenging clinical problem in Gastrointestinal practice that requires targeted diagnostic assessment to identify the underlying cause of the symptoms. Treatment is tailored according to the cause of NCCP: gastroesophageal reflux disease (GERD), esophageal dysmotility or functional Chest Pain. The purpose of this review is to discuss the current diagnosis and treatment of NCCP. Utilization of new diagnostic techniques such as pH-impedance and high-resolution esophageal manometry, and the introduction of a new definition for functional Chest Pain have helped to better diagnose the underlying mechanisms of NCCP. A better therapeutic approach toward GERD-related NCCP, the introduction of new interventions for symptoms due to esophageal spastic motor disorders and the expansion of the neuromodulator armamentarium for functional Chest Pain have changed the treatment landscape of NCCP. GERD is the most common esophageal cause of NCCP, followed by functional Chest Pain and esophageal dysmotility. The proton pump inhibitor test, upper endoscopy, wireless pH capsule and pH-impedance are used to identify GERD-induced NCCP. High-resolution esophageal manometry is the main tool to identify esophageal motor disorder in non-GERD-related NCCP. Negative diagnostic assessment suggests functional Chest Pain. Potent antireflux treatment is offered to patients with GERD-related NCCP; medical, endoscopic or surgical interventions are considered in esophageal dysmotility; and neuromodulators are prescribed for functional Chest Pain. Assessment and treatment of psychological comorbidity should be considered in all NCCP patients.
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systematic review with meta analysis selective serotonin reuptake inhibitors for Noncardiac Chest Pain
Alimentary Pharmacology & Therapeutics, 2015Co-Authors: D. K. Atluri, Ronnie Fass, Apoorva K. Chandar, Yngve FalckytterAbstract:Summary Background Selective serotonin reuptake inhibitors (SSRIs) are used to treat Noncardiac Chest Pain (NCCP) symptoms, however, data regarding their efficacy remains inconclusive. Aim To conduct a meta-analysis of randomised controlled trials (RCT) comparing SSRIs to placebo in patients with NCCP, and rate the quality of evidence. Methods Electronic databases were searched using the terms ‘Noncardiac Chest Pain’, ‘atypical Chest Pain’ and ‘selective serotonin reuptake inhibitors’. Data were extracted from RCTs of ≥8 weeks. Standardised mean differences (SMD), weighted mean differences (WMD) or risk ratios (RR) were used as summary statistics for pooled outcomes. GRADE methodology was used to rate the quality of evidence. Results Four RCTs (184 patients) met the inclusion criteria. Compared to placebo, patients on SSRIs showed a nonsignificant change in Chest Pain of 3½ points decrease on a 100 mm visual analogue scale (184 patients, 95% CI, −9.5 to 2.5; I2 = 0%). Change in depression scores was not significantly different between the two groups (88 patients; WMD = 0.7; 95% CI, −1.81 to 3.20; I2 = 64%). Treatment discontinuations were not significantly different between groups (154 patients, RR = 2.08; 95% CI, 0.77–5.60; I2 = 0%). The quality of evidence was rated as moderate for change in Chest Pain symptoms, low for change in depression scores and moderate for treatment discontinuation due to adverse events. Conclusions Selective serotonin reuptake inhibitors are not superior to placebo in improving Chest Pain or depression symptoms in patients with Noncardiac Chest Pain. Larger trials with longer follow-up periods are necessary to assess the benefits and drawbacks of SSRIs for the treatment of Noncardiac Chest Pain.
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Systematic review with meta‐analysis: selective serotonin reuptake inhibitors for Noncardiac Chest Pain
Alimentary pharmacology & therapeutics, 2014Co-Authors: D. K. Atluri, Ronnie Fass, Apoorva K. Chandar, Yngve Falck-ytterAbstract:Summary Background Selective serotonin reuptake inhibitors (SSRIs) are used to treat Noncardiac Chest Pain (NCCP) symptoms, however, data regarding their efficacy remains inconclusive. Aim To conduct a meta-analysis of randomised controlled trials (RCT) comparing SSRIs to placebo in patients with NCCP, and rate the quality of evidence. Methods Electronic databases were searched using the terms ‘Noncardiac Chest Pain’, ‘atypical Chest Pain’ and ‘selective serotonin reuptake inhibitors’. Data were extracted from RCTs of ≥8 weeks. Standardised mean differences (SMD), weighted mean differences (WMD) or risk ratios (RR) were used as summary statistics for pooled outcomes. GRADE methodology was used to rate the quality of evidence. Results Four RCTs (184 patients) met the inclusion criteria. Compared to placebo, patients on SSRIs showed a nonsignificant change in Chest Pain of 3½ points decrease on a 100 mm visual analogue scale (184 patients, 95% CI, −9.5 to 2.5; I2 = 0%). Change in depression scores was not significantly different between the two groups (88 patients; WMD = 0.7; 95% CI, −1.81 to 3.20; I2 = 64%). Treatment discontinuations were not significantly different between groups (154 patients, RR = 2.08; 95% CI, 0.77–5.60; I2 = 0%). The quality of evidence was rated as moderate for change in Chest Pain symptoms, low for change in depression scores and moderate for treatment discontinuation due to adverse events. Conclusions Selective serotonin reuptake inhibitors are not superior to placebo in improving Chest Pain or depression symptoms in patients with Noncardiac Chest Pain. Larger trials with longer follow-up periods are necessary to assess the benefits and drawbacks of SSRIs for the treatment of Noncardiac Chest Pain.
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Review Noncardiac Chest Pain: Epidemiology, Natural Course and Pathogenesis
2013Co-Authors: Ronnie Fass, Sami R. AchemAbstract:Noncardiac Chest Pain is defined as recurrent Chest Pain that is indistinguishable from ischemic heart Pain after a reasonable workup has excluded a cardiac cause. Noncardiac Chest Pain is a prevalent disorder resulting in high healthcare utilization and significant work absenteeism. However, despite its chronic nature, Noncardiac Chest Pain has no impact on patients ’ mortality. The main underlying mechanisms include gastroesophageal reflux, esophageal dysmotility and esophageal hypersensitivity. Gastroesophageal reflux disease is likely the most common cause of Noncardiac Chest Pain. Esophageal dysmotility affects only the minority of Noncardiac Chest Pain patients. Esophageal hypersensitivity may be present in non-GERD-related Noncardiac Chest Pain patients regardless if esophageal dysmotility is present or absent. Psychological co-morbidities such as panic disorder, anxiety, and depression are also common in Noncardiac Chest Pain patients and often modulate patients ’ perception of disease severity. (J Neurogastroenterol Motil 2011;17:110-123
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systematic review the treatment of Noncardiac Chest Pain
Alimentary Pharmacology & Therapeutics, 2012Co-Authors: T. Hershcovici, Sami R. Achem, Lokesh K. Jha, Ronnie FassAbstract:Aliment Pharmacol Ther 2012; 35: 5–14 Summary Background Treatment of Noncardiac Chest Pain (NCCP) remains a challenge. This is in part due to the heterogenous nature of this disorder. Several conditions are associated with NCCP including gastro-oesophageal reflux disease (GERD), oesophageal dysmotility, oesophageal hypersensitivity as well as others. Aim To determine the currently available therapeutic modalities for NCCP. Methods We performed a systematic review of the literature that was published between January, 1980 and March, 2011. We identified 734 studies; 68 of them met entry criteria. Results Patients with GERD-related NCCP should receive proton pump inhibitors (PPI) twice daily for at least 8 weeks. Smooth muscle relaxants are only recommended for temporary relief of NCCP with motility disorders. Botulinum toxin injection of the distal oesophagus may be effective in the treatment of NCCP and spastic oesophageal motility disorders. Studies assessing the value of tricyclic antidepressants, trazodone and selective serotonine reuptake inhibitors in NCCP are relatively small, but suggest an oesophageal analgesic effect in NCCP patients that is limited by their side effects profile. The usage of theophylline to treat patients with non-GERD-related NCCP should be weighed against its potential toxicity. Use of complementary medicine has been scarcely studied in NCCP. Patients with coexisting psychological morbidity or those not responding to any medical therapy should be considered for psychological intervention. Cognitive behavioural therapy and hypnotherapy may be useful in the treatment of NCCP. Conclusions Patients with GERD-related Noncardiac Chest Pain should be treated with at least double dose PPI. The primary treatment for non-GERD-related Noncardiac Chest Pain, regardless if oesophageal dysmotility is present, is Pain modulators.
Sami R. Achem - One of the best experts on this subject based on the ideXlab platform.
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Noncardiac Chest Pain
Functional and Motility Disorders of the Gastrointestinal Tract, 2014Co-Authors: Sami R. AchemAbstract:Noncardiac Chest Pain (NCCP) is a major source of healthcare expenditure and disability. Recent data indicate that 5.5 million patients visited emergency departments in the United States with the chief complaint of Chest Pain during 2007–2008. Chest Pain is the second most common cause for emergency room visits after abdominal Pain. NCCP is one of the most frequent causes of hospital admission in the Western world. In England and Wales, acute Chest Pain is responsible for approximately 700,000 patient visits annually at emergency departments and 20–30 % of emergency medical admissions.
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Review Noncardiac Chest Pain: Epidemiology, Natural Course and Pathogenesis
2013Co-Authors: Ronnie Fass, Sami R. AchemAbstract:Noncardiac Chest Pain is defined as recurrent Chest Pain that is indistinguishable from ischemic heart Pain after a reasonable workup has excluded a cardiac cause. Noncardiac Chest Pain is a prevalent disorder resulting in high healthcare utilization and significant work absenteeism. However, despite its chronic nature, Noncardiac Chest Pain has no impact on patients ’ mortality. The main underlying mechanisms include gastroesophageal reflux, esophageal dysmotility and esophageal hypersensitivity. Gastroesophageal reflux disease is likely the most common cause of Noncardiac Chest Pain. Esophageal dysmotility affects only the minority of Noncardiac Chest Pain patients. Esophageal hypersensitivity may be present in non-GERD-related Noncardiac Chest Pain patients regardless if esophageal dysmotility is present or absent. Psychological co-morbidities such as panic disorder, anxiety, and depression are also common in Noncardiac Chest Pain patients and often modulate patients ’ perception of disease severity. (J Neurogastroenterol Motil 2011;17:110-123
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systematic review the treatment of Noncardiac Chest Pain
Alimentary Pharmacology & Therapeutics, 2012Co-Authors: T. Hershcovici, Sami R. Achem, Lokesh K. Jha, Ronnie FassAbstract:Aliment Pharmacol Ther 2012; 35: 5–14 Summary Background Treatment of Noncardiac Chest Pain (NCCP) remains a challenge. This is in part due to the heterogenous nature of this disorder. Several conditions are associated with NCCP including gastro-oesophageal reflux disease (GERD), oesophageal dysmotility, oesophageal hypersensitivity as well as others. Aim To determine the currently available therapeutic modalities for NCCP. Methods We performed a systematic review of the literature that was published between January, 1980 and March, 2011. We identified 734 studies; 68 of them met entry criteria. Results Patients with GERD-related NCCP should receive proton pump inhibitors (PPI) twice daily for at least 8 weeks. Smooth muscle relaxants are only recommended for temporary relief of NCCP with motility disorders. Botulinum toxin injection of the distal oesophagus may be effective in the treatment of NCCP and spastic oesophageal motility disorders. Studies assessing the value of tricyclic antidepressants, trazodone and selective serotonine reuptake inhibitors in NCCP are relatively small, but suggest an oesophageal analgesic effect in NCCP patients that is limited by their side effects profile. The usage of theophylline to treat patients with non-GERD-related NCCP should be weighed against its potential toxicity. Use of complementary medicine has been scarcely studied in NCCP. Patients with coexisting psychological morbidity or those not responding to any medical therapy should be considered for psychological intervention. Cognitive behavioural therapy and hypnotherapy may be useful in the treatment of NCCP. Conclusions Patients with GERD-related Noncardiac Chest Pain should be treated with at least double dose PPI. The primary treatment for non-GERD-related Noncardiac Chest Pain, regardless if oesophageal dysmotility is present, is Pain modulators.
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Systematic review: the treatment of Noncardiac Chest Pain
Alimentary pharmacology & therapeutics, 2011Co-Authors: T. Hershcovici, Sami R. Achem, Lokesh K. Jha, Ronnie FassAbstract:Treatment of Noncardiac Chest Pain (NCCP) remains a challenge. This is in part due to the heterogeneous nature of this disorder. Several conditions are associated with NCCP including gastro-oesophageal reflux disease (GERD), oesophageal dysmotility, oesophageal hypersensitivity as well as others. To determine the currently available therapeutic modalities for NCCP. We performed a systematic review of the literature that was published between January, 1980 and March, 2011. We identified 734 studies; 68 of them met entry criteria. Patients with GERD-related NCCP should receive proton pump inhibitors (PPI) twice daily for at least 8 weeks. Smooth muscle relaxants are only recommended for temporary relief of NCCP with motility disorders. Botulinum toxin injection of the distal oesophagus may be effective in the treatment of NCCP and spastic oesophageal motility disorders. Studies assessing the value of tricyclic antidepressants, trazodone and selective serotonin reuptake inhibitors in NCCP are relatively small, but suggest an oesophageal analgesic effect in NCCP patients that is limited by their side effects profile. The usage of theophylline to treat patients with non-GERD-related NCCP should be weighed against its potential toxicity. Use of complementary medicine has been scarcely studied in NCCP. Patients with coexisting psychological morbidity or those not responding to any medical therapy should be considered for psychological intervention. Cognitive behavioural therapy and hypnotherapy may be useful in the treatment of NCCP. Patients with GERD-related Noncardiac Chest Pain should be treated with at least double dose PPI. The primary treatment for non-GERD-related Noncardiac Chest Pain, regardless if oesophageal dysmotility is present, is Pain modulators. © 2011 Blackwell Publishing Ltd.
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Noncardiac Chest Pain: diagnostic evaluation
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 2011Co-Authors: Ronnie Fass, Sami R. AchemAbstract:Noncardiac Chest Pain (NCCP) is a common and challenging clinical problem. It is estimated that more than 70 million Americans (23% of the population) suffer from this condition yearly. Patients with NCCP represent a diagnostic dilemma. Their Chest Pain is often indistinguishable from cardiac Pain leading to extensive and expensive evaluations. Once coronary artery disease and other cardiac and pulmonary sources of Chest Pain are excluded, patients are frequently referred to gastroenterologists to look primarily for esophageal sources of Pain. A variety of diagnostic tests are available to the practicing clinician to identify the origin of Pain, including ambulatory pH testing, esophageal motility, upper endoscopy, provocative testing and even therapeutic trials.
Abby J. Fyer - One of the best experts on this subject based on the ideXlab platform.
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Noncardiac Chest Pain and psychopathology in children and adolescents
Journal of Psychosomatic Research, 2005Co-Authors: Joshua D. Lipsitz, Howard D. Apfel, Zvi Marans, Carrie L. Masia, Merav Gur, Heather Dent, Abby J. FyerAbstract:Abstract Objective We sought to examine the prevalence of DSM-IV psychiatric disorders in children and adolescents with complaints of Noncardiac Chest Pain (NCCP). Method We assessed 27 youngsters (ages 8–17 years) referred to a pediatric cardiology practice with complaints of NCCP. Each child and a parent were interviewed using the Anxiety Disorders Interview Schedule for Children. Results Sixteen youngsters (59%) were diagnosed with a current DSM-IV disorder. Fifteen (56%) had a current anxiety disorder, nine of whom were diagnosed with panic disorder. One participant was diagnosed with a depressive disorder. Conclusion Results of this preliminary study suggest that DSM-IV anxiety disorders may be common in youngsters with NCCP. No evidence was found for high prevalence of depression in this sample. Larger controlled studies are needed to determine the prevalence and impact of psychopathology in youngsters with NCCP.
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Noncardiac Chest Pain and psychopathology in children and adolescents.
Journal of psychosomatic research, 2005Co-Authors: Joshua D. Lipsitz, Howard D. Apfel, Zvi Marans, Carrie L. Masia, Merav Gur, Heather Dent, Abby J. FyerAbstract:We sought to examine the prevalence of DSM-IV psychiatric disorders in children and adolescents with complaints of Noncardiac Chest Pain (NCCP). We assessed 27 youngsters (ages 8-17 years) referred to a pediatric cardiology practice with complaints of NCCP. Each child and a parent were interviewed using the Anxiety Disorders Interview Schedule for Children. Sixteen youngsters (59%) were diagnosed with a current DSM-IV disorder. Fifteen (56%) had a current anxiety disorder, nine of whom were diagnosed with panic disorder. One participant was diagnosed with a depressive disorder. Results of this preliminary study suggest that DSM-IV anxiety disorders may be common in youngsters with NCCP. No evidence was found for high prevalence of depression in this sample. Larger controlled studies are needed to determine the prevalence and impact of psychopathology in youngsters with NCCP.
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Anxiety and Depressive Symptoms and Anxiety Sensitivity in Youngsters With Noncardiac Chest Pain and Benign Heart Murmurs
Journal of pediatric psychology, 2004Co-Authors: Joshua D. Lipsitz, Carrie Masia-warner, Howard D. Apfel, Zvi Marans, Beth Hellstern, Nicholas R. Forand, Yosef Levenbraun, Abby J. FyerAbstract:Chest Pain in children and adolescents is rarely associated with cardiac disease. We sought to examine psychological symptoms in youngsters with medically unexplained Chest Pain. We hypothesized that children and adolescents with medically unexplained Chest Pain would have high rates of anxiety and depressive symptoms. We assessed 65 youngsters with Noncardiac Chest Pain (NCCP) and 45 comparison youngsters with benign heart murmurs using self-report measures of anxiety and depressive symptoms and anxiety sensitivity. Compared with the asymptomatic benign-murmur group, youngsters with NCCP had higher levels of some anxiety symptoms and anxiety sensitivity. Differences on depressive symptoms were not significant. Though preliminary, results suggest that youngsters with Chest Pain may experience increased levels of some psychological symptoms. Future studies of Noncardiac Chest Pain in youngsters should include larger samples and comprehensive diagnostic assessments as well as long-term follow-up evaluations.
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anxiety and depressive symptoms and anxiety sensitivity in youngsters with Noncardiac Chest Pain and benign heart murmurs
Journal of Pediatric Psychology, 2004Co-Authors: Joshua D. Lipsitz, Howard D. Apfel, Zvi Marans, Beth Hellstern, Nicholas R. Forand, Yosef Levenbraun, Carrie Masiawarner, Abby J. FyerAbstract:Objective Chest Pain in children and adolescents is rarely associated with cardiac disease. We sought to examine psychological symptoms in youngsters with medically unexplained Chest Pain. We hypothesized that children and adolescents with medically unexplained Chest Pain would have high rates of anxiety and depressive symptoms. Methods We assessed 65 youngsters with Noncardiac Chest Pain (NCCP) and 45 comparison youngsters with benign heart murmurs using self-report measures of anxiety and depressive symptoms and anxiety sensitivity. Results Compared with the asymptomatic benign-murmur group, youngsters with NCCP had higher levels of some anxiety symptoms and anxiety sensitivity. Differences on depressive symptoms were not significant. Conclusions Though preliminary, results suggest that youngsters with Chest Pain may experience increased levels of some psychological symptoms. Future studies of Noncardiac Chest Pain in youngsters should include larger samples and comprehensive diagnostic assessments as well as long-term follow-up evaluations.
Joshua D. Lipsitz - One of the best experts on this subject based on the ideXlab platform.
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Panic Disorder in Children and Adolescents with Noncardiac Chest Pain
Child psychiatry and human development, 2013Co-Authors: Michal Achiam-montal, Lee Tibi, Joshua D. LipsitzAbstract:Adults with panic disorder (PD) often present to medical settings with Noncardiac Chest Pain (NCCP), but less is known about children and adolescents with this complaint. We sought to characterize PD in youth with NCCP and compare features with PD in youth in psychiatric outpatient settings. Using a semi-structured diagnostic interview we evaluated 132 youth (ages 8-17) with NCCP recruited from two medical settings. Twenty-seven (20.5 %) met full DSM-IV criteria for PD, eleven of which were children (
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panic disorder in children and adolescents with Noncardiac Chest Pain
Child Psychiatry & Human Development, 2013Co-Authors: Michal Achiammontal, Lee Tibi, Joshua D. LipsitzAbstract:Adults with panic disorder (PD) often present to medical settings with Noncardiac Chest Pain (NCCP), but less is known about children and adolescents with this complaint. We sought to characterize PD in youth with NCCP and compare features with PD in youth in psychiatric outpatient settings. Using a semi-structured diagnostic interview we evaluated 132 youth (ages 8–17) with NCCP recruited from two medical settings. Twenty-seven (20.5 %) met full DSM-IV criteria for PD, eleven of which were children (<13 years). Most frequent panic symptoms were somatic complaints, although cognitive symptoms were also common. Only 14.8 % had clinically significant agoraphobia. Comorbid anxiety disorders and major depression were common. Overall, clinical features of PD among youth with NCCP are similar to PD in psychiatric settings. Interventions for PD may benefit youth who present initially with NCCP. Systematic psychiatric screening could increase detection of PD and improve care for this population.
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Noncardiac Chest Pain and psychopathology in children and adolescents
Journal of Psychosomatic Research, 2005Co-Authors: Joshua D. Lipsitz, Howard D. Apfel, Zvi Marans, Carrie L. Masia, Merav Gur, Heather Dent, Abby J. FyerAbstract:Abstract Objective We sought to examine the prevalence of DSM-IV psychiatric disorders in children and adolescents with complaints of Noncardiac Chest Pain (NCCP). Method We assessed 27 youngsters (ages 8–17 years) referred to a pediatric cardiology practice with complaints of NCCP. Each child and a parent were interviewed using the Anxiety Disorders Interview Schedule for Children. Results Sixteen youngsters (59%) were diagnosed with a current DSM-IV disorder. Fifteen (56%) had a current anxiety disorder, nine of whom were diagnosed with panic disorder. One participant was diagnosed with a depressive disorder. Conclusion Results of this preliminary study suggest that DSM-IV anxiety disorders may be common in youngsters with NCCP. No evidence was found for high prevalence of depression in this sample. Larger controlled studies are needed to determine the prevalence and impact of psychopathology in youngsters with NCCP.
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Noncardiac Chest Pain and psychopathology in children and adolescents.
Journal of psychosomatic research, 2005Co-Authors: Joshua D. Lipsitz, Howard D. Apfel, Zvi Marans, Carrie L. Masia, Merav Gur, Heather Dent, Abby J. FyerAbstract:We sought to examine the prevalence of DSM-IV psychiatric disorders in children and adolescents with complaints of Noncardiac Chest Pain (NCCP). We assessed 27 youngsters (ages 8-17 years) referred to a pediatric cardiology practice with complaints of NCCP. Each child and a parent were interviewed using the Anxiety Disorders Interview Schedule for Children. Sixteen youngsters (59%) were diagnosed with a current DSM-IV disorder. Fifteen (56%) had a current anxiety disorder, nine of whom were diagnosed with panic disorder. One participant was diagnosed with a depressive disorder. Results of this preliminary study suggest that DSM-IV anxiety disorders may be common in youngsters with NCCP. No evidence was found for high prevalence of depression in this sample. Larger controlled studies are needed to determine the prevalence and impact of psychopathology in youngsters with NCCP.
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Anxiety and Depressive Symptoms and Anxiety Sensitivity in Youngsters With Noncardiac Chest Pain and Benign Heart Murmurs
Journal of pediatric psychology, 2004Co-Authors: Joshua D. Lipsitz, Carrie Masia-warner, Howard D. Apfel, Zvi Marans, Beth Hellstern, Nicholas R. Forand, Yosef Levenbraun, Abby J. FyerAbstract:Chest Pain in children and adolescents is rarely associated with cardiac disease. We sought to examine psychological symptoms in youngsters with medically unexplained Chest Pain. We hypothesized that children and adolescents with medically unexplained Chest Pain would have high rates of anxiety and depressive symptoms. We assessed 65 youngsters with Noncardiac Chest Pain (NCCP) and 45 comparison youngsters with benign heart murmurs using self-report measures of anxiety and depressive symptoms and anxiety sensitivity. Compared with the asymptomatic benign-murmur group, youngsters with NCCP had higher levels of some anxiety symptoms and anxiety sensitivity. Differences on depressive symptoms were not significant. Though preliminary, results suggest that youngsters with Chest Pain may experience increased levels of some psychological symptoms. Future studies of Noncardiac Chest Pain in youngsters should include larger samples and comprehensive diagnostic assessments as well as long-term follow-up evaluations.
Shiu Kum Lam - One of the best experts on this subject based on the ideXlab platform.
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psychosocial factors in patients with Noncardiac Chest Pain
Psychosomatic Medicine, 2003Co-Authors: Cecilia Cheng, Wai-man Wong, Kam Chuen Lai, Benjamin C.y. Wong, Wai-mo Hui, Shiu Kum LamAbstract:OBJECTIVE: This study sought to explore some psychosocial factors that distinguished individuals with Noncardiac Chest Pain (NCCP) from those without NCCP, and whether these psychosocial factors were associated with anxiety and depression that are co-morbid factors of NCCP. METHODS: A matched case-control design was adopted to compare differences in psychosocial factors among a target group of patients with NCCP (N = 70), a Pain control group of patients with rheumatism (N = 70), and a community control group of healthy individuals (N = 70). RESULTS: Compared with subjects from the two control groups, NCCP patients tended to monitor more, use more problem-focused coping, display a coping pattern with a poorer strategy-situation fit, and receive less emotional support in times of stress. Moreover, monitoring perceptual style and problem-focused coping were associated with higher levels of anxiety and depression. Coping pattern with a strategy-situation fit and emotional support were related to lower levels of anxiety and depression. CONCLUSIONS: The present new findings suggest that monitoring perceptual style and inflexible coping style are risk factors that enhance one's vulnerability to NCCP. Emotional support may be a resource factor that reduces one's susceptibility to NCCP.
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Psychosocial factors in patients with Noncardiac Chest Pain.
Psychosomatic medicine, 2003Co-Authors: Cecilia Cheng, Wai-man Wong, Kam Chuen Lai, Benjamin C.y. Wong, Wai-mo Hui, Shiu Kum LamAbstract:This study sought to explore some psychosocial factors that distinguished individuals with Noncardiac Chest Pain (NCCP) from those without NCCP, and whether these psychosocial factors were associated with anxiety and depression that are co-morbid factors of NCCP. A matched case-control design was adopted to compare differences in psychosocial factors among a target group of patients with NCCP (N = 70), a Pain control group of patients with rheumatism (N = 70), and a community control group of healthy individuals (N = 70). Compared with subjects from the two control groups, NCCP patients tended to monitor more, use more problem-focused coping, display a coping pattern with a poorer strategy-situation fit, and receive less emotional support in times of stress. Moreover, monitoring perceptual style and problem-focused coping were associated with higher levels of anxiety and depression. Coping pattern with a strategy-situation fit and emotional support were related to lower levels of anxiety and depression. The present new findings suggest that monitoring perceptual style and inflexible coping style are risk factors that enhance one's vulnerability to NCCP. Emotional support may be a resource factor that reduces one's susceptibility to NCCP.