Chest pain, depression and anxiety in CHD (tracked changes)_revision 3.pdf (368.84 kB)
Chest pain, depression and anxiety in coronary heart disease: consequence or cause? A prospective clinical study in primary care
journal contribution
posted on 2023-06-10, 01:05 authored by Eric W de Heer, Jorge E Palacios, Herman J Adèr, Harm van MarwijkHarm van Marwijk, Andre Tylee, Christina M van der Feltz-CornelisObjective To examine if chest pain increases the risk of depression and anxiety, or, on the other hand, depression and anxiety increase the risk of chest pain onset in patients with coronary heart disease (CHD). Design Prospective clinical study. Setting 16 general practices in the Greater London Primary Care Research Network. Participants 803 participants with a confirmed diagnosis of CHD at baseline on the Quality and Outcomes Framework (QOF) CHD registers. Main outcome measures Rose Angina Questionnaire, HADS depression and anxiety subscales and PHQ-9 were assessed at seven time points, each 6 months apart. Multi-Level Analysis (MLA) and Structural Equation Modelling (SEM) were applied. Results Chest pain predicts both more severe anxiety and depression symptoms at all time points until 30 months after baseline. However, although anxiety predicted chest pain in the short term with a strong association, this association did not last after 18 months. Depression had only a small, negative association with chest pain. Conclusions In persons with CHD, chest pain increases the risk of both anxiety and depression to a great extent. However, anxiety and depression have only limited effects on the risk for chest pain. This evidence suggests that anxiety and depression tend to be consequences rather than causes of cardiac chest pain. Intervention studies that support persons with CHD by providing this information should be devised and evaluated, thus deconstructing potentially catastrophic cognitions and strengthening emotional coping.
History
Publication status
- Published
File Version
- Accepted version
Journal
Journal of Psychosomatic ResearchISSN
0022-3999Publisher
ElsevierExternal DOI
Volume
129Page range
1-6Article number
a109891Event location
EnglandDepartment affiliated with
- Primary Care and Public Health Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2021-09-23First Open Access (FOA) Date
2021-09-23First Compliant Deposit (FCD) Date
2021-09-23Usage metrics
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