Prevalence of Chest Pain, Depression, Somatization, Anxiety, Global Distress, and Substance Use among Cardiac and Pulmonary Rehabilitation Patients

Abstract

Psychosocial factors of cardiovascular disease receive a preponderance of attention. Little attention is paid to psychosocial factors of pulmonary disease. This paper sought to describe psychosocial characteristics and to identify differences between cardiac and pulmonary patients entering a phase II rehabilitation program. Parametric and nonparametric analyses were conducted to examine scores on the Brief Symptom Inventory-18 (BSI-18) and the CAGE-D, administered at entry as standard clinical care. Participants were 163 cardiac and 63 pulmonary patients. Scores on the BSI-18 “chest pain” item indicated that more cardiac patients report chest pain than pulmonary patients. Among all subjects, chest pain ratings were positively related to anxiety, depression, and global distress. There were equivocal proportions of anxiety and somatization in patient groups. Pulmonary patients were more likely to endorse clinically significant levels of depression and global psychological distress than cardiac patients. Cardiac patients were significantly more likely to screen positively on the CAGE-D than pulmonary patients. Findings show a relationship between symptoms of chest pain and psychological distress. Despite equivalent proportions of anxiety and somatization between groups, a greater proportion of pulmonary patients reported symptoms of depression and global psychological distress, while more cardiac patients reported chest pain. Further research is needed to examine this paradigm.

Association of Somatic Symptom Severity With Sociodemographic Parameters In Patients With Medically Unexplained Physical Symptoms: A Cross-Sectional Study From a Tertiary Care Center in India

“…It is directly related to the sense of well-being, quality of life, and health care expenses [ 10 , 11 ]. The study of somatic symptom burden has attracted the interests of researchers from different parts of the world and researchers have studied it in common clinical conditions such as anxiety, depression, chronic obstructive pulmonary disease (COPD), and cardiac illnesses [ 12 - 14 ]. In a large study involving 1,329 patients with anxiety and depression disorders, it has been found that 72.2%, 20.7%, and 7.1% of patients had a minimal/mild, medium, and high level of somatic symptom severity, respectively [ 12 ].…”

Mind and body: how the health of the body impacts on neuropsychiatry

“…Up to 20% of patients with coronary heart disease meet diagnostic criteria for major depression, and up to 47% report significant and long-lasting depressive symptoms (Bush et al, 2005 ; Carney and Freedland, 2008 ). Recent reports have indicated that this effect is not restricted to individuals with cardiovascular disease, as patients undergoing rehabilitation for pulmonary disease were even more likely than cardiac patients to exhibit clinically significant depression and psychological distress (Serber et al, 2012 ). Cardiovascular risk factors are pathologically relevant even prior to diagnosis.…”

Validity of the Brief Symptom Inventory-18 (BSI-18) for identifying depression and anxiety in young adult cancer survivors: Comparison with a Structured Clinical Diagnostic Interview.

“…The Brief Symptom Inventory-18 (BSI-18; Derogatis, 2001) is an 18-item Self-Report Checklist measure developed as a brief screen for psychological symptoms in medical patients. The BSI-18 has been widely used in research and clinical applications with a variety of patient populations (e.g., Derogatis & Melisaratos, 1983; Mustanski, Garofalo, Herrick, & Donenberg, 2007; Petkus et al, 2010; Serber et al, 2012), including oncology samples (Bober et al, 2013; Galdon et al, 2008; Kwak et al, 2013b; Merport, Bober, Grose, & Recklitis, 2012; Michel, Rebholz, von der Weid, Bergstraesser, & Kuehni, 2010; Michel & Vetsch, 2015; Zabora, 2015; Zabora et al, 2001; Zeltzer et al, 2009). Application of the BSI-18 to oncology patients is supported by its brevity, its coverage of the critical areas of anxiety and depression, and the published manual’s inclusion of normative data for an oncology sample.…”