Anxiety, depression, suicidal ideation, and stressful life events in non-cardiac adolescent chest pain: a comparative study about the hidden part of the iceberg

• Published in: Cardiology in the young 2017-08, Vol.27 (6), p.1098-1103
• Main Authors: Eliacik, Kayi, Kanik, Ali, Bolat, Nurullah, Mertek, Hilal, Guven, Baris, Karadas, Ulas, Dogrusoz, Buket, Bakiler, Ali Rahmi
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Age; Anxiety; Anxiety - epidemiology; Anxiety - etiology; Anxiety - psychology; Bullying; Cardiology; Chest; Chest Pain - complications; Chest Pain - psychology; Child & adolescent psychiatry; Children; Children & youth; Comparative studies; Coronary artery disease; Depression - epidemiology; Depression - etiology; Depression - psychology; Extracurricular activities; Families & family life; Female; Gender; Health problems; Heart diseases; Hospitals; Humans; Incidence; Male; Mental depression; Mental health; Original Articles; Pain; Physicians; Population studies; Psychological stress; Psychopathology; Regression analysis; Risk analysis; Risk Assessment; Risk Factors; Sex crimes; Stress, Psychological - epidemiology; Stress, Psychological - etiology; Stress, Psychological - psychology; Suicidal Ideation; Suicides & suicide attempts; Teenagers; Turkey - epidemiology
• ISSN: 1047-9511; 1467-1107
• DOI: 10.1017/S1047951116002109

Chest pain in adolescents is rarely associated with cardiac disease. Adolescents with medically unexplained chest pain usually have high levels of anxiety and depression. Psychological stress may trigger non-cardiac chest pain. This study evaluated risk factors that particularly characterise adolescence, such as major stressful events, in a clinical population. The present study was conducted on 100 adolescents with non-cardiac chest pain and 76 control subjects. Stressful life events were assessed by interviewing patients using a 36-item checklist, along with the Children’s Depression Inventory and Spielberger’s State-Trait Anxiety Inventory for children, in both groups. Certain stressful life events, suicidal thoughts, depression, and anxiety were more commonly observed in adolescents with non-cardiac chest pain compared with the control group. Moreover, binary logistic regression analysis showed that trouble with bullies, school-related problems, and depression may trigger non-cardiac chest pain in adolescents. Non-cardiac chest pain on the surface may point to the underlying psychosocial health problems such as depression, suicidal ideas, or important life events such as academic difficulties or trouble with bullies. The need for a psychosocial evaluation that includes assessment of negative life events and a better management have been discussed in light of the results.