Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-24T00:44:02.542Z Has data issue: false hasContentIssue false
  • English
  • Français

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 online by Cambridge University Press:  10 November 2016

Kayi Eliacik ,
Ali Kanik ,
Nurullah Bolat ,
Hilal Mertek ,
Baris Guven ,
Ulas Karadas ,
Buket Dogrusoz  and
Ali Rahmi Bakiler
Kayi Eliacik*
Affiliation:
Division of Adolescent Medicine, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
Ali Kanik
Affiliation:
Department of Paediatrics, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
Nurullah Bolat
Affiliation:
Department of Child and Adolescent Psychiatry, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
Hilal Mertek
Affiliation:
Division of Adolescent Medicine, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
Baris Guven
Affiliation:
Department of Paediatric Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
Ulas Karadas
Affiliation:
Department of Paediatric Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
Buket Dogrusoz
Affiliation:
Department of Paediatric Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
Ali Rahmi Bakiler
Affiliation:
Department of Paediatric Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
*
Correspondence to: K. Eliacik, MD, Department of Paediatrics, Division of Adolescent Medicine, Tepecik Training and Research Hospital, Izmir, Yenisehir, Turkey. Tel: 0090 232 4696969/3460; Fax: +90 232 4330756; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

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.

Keywords

Chest paindepressionsuicidal thoughtsstressful life eventsadolescents
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 6 , August 2017 , pp. 1098 - 1103
Check for updates
Copyright
© Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Selbst, SM. Approach to the child with chest pain. Pediatr Clin N Am 2010; 57: 1221–1234.CrossRefGoogle Scholar
2. Thull-Freedman, J. Evaluation of chest pain in the pediatric patient. Med Clin N Am 2010; 94: 327–347.Google Scholar
3. Brenner, JI, Ringel, RE, Berman, MA. Cardiologic perspectives of chest pain in childhood: a referral problem? To whom? Pediatr Clin North Am 1984; 31: 1241–1258.Google Scholar
4. Fyfe, DA, Moodie, DS. Chest pain in pediatric patients presenting to a cardiac clinic. Clin Pediatr (Phila) 1984; 23: 321–324.Google Scholar
5. Taylor, GL, Murphy, NF, Berry, C, et al. Long-term outcome of low-risk patients attending a rapid assessment chest pain clinic. Heart 2008; 94: 628–632.Google Scholar
6. Scholz, M, Wegener, K, Unverboden, M, Klepzig, H. Long term outcome in patients with angina-like chest pain and normal coronary angiograms. Herz 2003; 28: 413–420.Google Scholar
7. Roll, M, Rosenqvist, M, Sjöborg, B. Unexplained acute chest pain in young adults: disease patterns and medication use 25 years later. Psychosom Med 2015; 77: 567–574.CrossRefGoogle ScholarPubMed
8. Selbst, SM, Ruddy, RM, Clark, BJ, Henretig, FM, Santulli, T Jr. Pediatric chest pain: a prospective study. Pediatrics 1988; 82: 319–323.Google Scholar
9. Khairandish, Z, Jamali, L, Haghbin, S. Role of anxiety and depression in adolescents with chest pain referred to a cardiology clinic. Cardiol Young 2016; 16: 1–6.Google Scholar
10. Tunaoglu, FS, Olguntürk, R, Akcabay, S, Oguz, D, Gücüyener, K, Demirsoy, S. Chest pain in children referred to a cardiology clinic. Pediatr Cardiol 1995; 16: 69–72.CrossRefGoogle ScholarPubMed
11. Lipsitz, JD, Warner, CM, Apfel, H, et al. Anxiety and depressive symptoms and anxiety sensitivity in youngsters with noncardiac chest pain and benign heart murmurs. J Pediatr Psychol 2004; 29: 607–612.CrossRefGoogle ScholarPubMed
12. Aggarwal, S, Prabhu, CH, Anand, LC, Kotwal, LC. Stressful life events among adolescents: the development of a new measure. Indian J Psychiatry 2007; 49: 96–102.Google Scholar
13. Wang, H, Hao, J, Tao, F, Zhu, P, Zhang, J. Mediator effects of negative coping styles between stressful life events and sub-health symptoms. Chinese J School Health 2011; 32: 943–945.Google Scholar
14. Kovacs, M. Rating scale to assess depression in school aged children. Acta Paedopsychiatr 1981; 46: 305–315.Google Scholar
15. Öy, B. Çocuklar için depresyon ölçeği: Geçerlik ve güvenirlik çalışması. Türk Psikiyatri Dergisi 1991; 2: 132–136.Google Scholar
16. Spielberger, CD. Manual for the State-Trait Anxiety for Children. Consulting Psychologists Press, Palo-Alto, 1973.Google Scholar
17. Özusta, Ş. Çocuklar İçin Durumluk-Sürekli Kaygı Envanterinin Uyarlama, Geçerlik ve Güvenirlik Çalışması. Türk Psikoloji Dergisi 1995; 10: 32–44.Google Scholar
18. Aro, H, Paronen, O, Aro, S. Psychosomatic symptoms among 14–16 year old Finnish adolescents. Soc Psychiatry 1987; 22: 171–176.Google Scholar
19. Kandel, DB, Davies, M. Epidemiology of depressive mood in adolescents, an empirical study. Arch Gen Psychiartry 1982; 39: 1205–1212.Google Scholar
20. Miaskowski, C. The role of sex and gender in pain perception and responses to treatment. In: Gatchel RJ, Turk DC, (eds.) Psychosocial Factors in Pain: Critical Perspectives. Guilford Press, New York, New York, 1999, pp. 401–411.Google Scholar
21. Juvonen, J, Nishina, A, Graham, S. Peer harassment, psychological adjustment, and school functioning in early adolescence. J Educational Psychology 2000; 92: 349–359.CrossRefGoogle Scholar
22. Massie, H, Szajnberg, N. My life is longing: child abuse and its adult sequelae results of the brody longitudinal study from birth to age 30. Int J Psychoanal 2006; 87: 471–496.Google Scholar
23. Strøm, IF, Thoresen, S, Wentzel-Larsen, T, Dyb, G. Violence, bullying and academic achivement: a study of 15-year-old adolescents and their school environment. Child Abuse Negl 2013; 37: 243–251.CrossRefGoogle Scholar
24. Gini, G. Associations between bullying behaviour, psychosomatic complaints, emotional and behavioural problems. J Paediatr Child Health 2008; 44: 492–497.Google Scholar
25. Kumpulainen, K, Räsänen, E, Puura, K. Psychiatric disorders and the use of mental health services among children involved in bullying. Aggr Behav 2001; 27: 102–110.Google Scholar
26. Fekkes, M, Pijpers, FI, Verloove-Vanhorick, SP. Bullying behavior and associations with psychosomatic complaints and depression in victims. J Pediatr 2004; 144: 17–22.CrossRefGoogle ScholarPubMed
27. Davies, M, Cunningham, G. Adolescent parasuicide in Foyle area. Ir J Psychol Med 1999; 16: 9–12.Google Scholar
28. Murberg, TA, Bru, E. School-related stress and psychosomatic symptoms among Norwegian adolescents. School Psychol Int 2004; 25: 317–322.Google Scholar
29. Aro, H, Hänninen, V, Paronen, O. Social support, life events and psychosomatic symptoms among 14–16-year-old adolescents. Soc Sci Med 1989; 29: 1051–1056.Google Scholar
30. Garralda, ME. A selective review of child psychiatric syndrome with a somatic presentation. Br J Psychiatry 1992; 161: 759–773.Google Scholar
31. Mourad, G, Strömberg, A, Johansson, P, Jaarsma, T. Depressive symptoms, cardiac anxiety, and fear of body sensations in patients with non-cardiac chest pain, and their relation to healthcare-seeking behavior: a cross sectional study. Patient 2016; 9: 69–77.CrossRefGoogle ScholarPubMed
32. Basara, G, Baydin, A, Yilmaz, A, Yucel, O, Erenler, AK, Murat, N. Investigation of anxiety levels of patients with chest pain admitted to emergency department. Turk J Emerg Med 2016; 15: 168–171.CrossRefGoogle ScholarPubMed
33. Gilleland, J, Blount, RL, Campbell, RM, Johnson, GL, Dooley, KJ, Simpson, P. Brief report: psychosocial factors and pediatric noncardiac chest pain. J Pediatr Psychol 2009; 34: 1170–1174.CrossRefGoogle ScholarPubMed
34. Dekker, MC, Ferdinand, RF, van Lang, NDJ, Bongers, L, van der Ende, J, Verhulst, FC. Developmental trajectories of depressive symptoms from early childhood to late adolescence: gender differences and adult outcome. J Child Psychol Psychiatry 2007; 48: 657–666.CrossRefGoogle ScholarPubMed
35. Maes, M, Mylle, J, Delmeire, L, Janca, A. Pre- and post-disaster negative life events in relation to the incidence and severity of post-traumatic stress disorder. Psychiatry Res 2001; 105: 1–12.Google Scholar
36. Aktekin, M, Karaman, T, Senol, YY, Erdem, S, Erengin, H, Akaydin, M. Anxiety, depression and stressful life events among medical students: a prospective study in Antalya, Turkey. Med Educ 2001; 35: 12–17.Google Scholar
37. Karlidag, R, Unal, S, Evereklioglu, C, Sipahi, B, Er, H, Yologlu, S. Stressful life events, anxiety, depression and coping mechanisms in patients with Behçet’s disease. J Eur Acad Dermatol Venereol 2003; 17: 670–675.CrossRefGoogle ScholarPubMed
38. Low, NC, Dugas, E, O’Loughlin, E, et al. Common stressful life events and difficulties are associated with mental health symptoms and substance use in young adolescents. BMC Psychiatry 2012; 12: 116.CrossRefGoogle ScholarPubMed
39. Surís, JC, Bélanger, RE, Ambresin, AE, Chabloz, JM, Michaud, PA. Extra burden of psychosomatic complaints among adolescents suffering from chronic conditions. J Dev Behav Pediatr 2011; 32: 328–331.Google Scholar
40. Cao, H, Tao, FB, Huang, L, et al. Situation of common psychosomatic symptom in adolescent and its influence on 6 months later suicide and self-injurious behavior. Zhonghua Yu Fang Yi Xue Za Zhi 2012; 46: 202–208.Google ScholarPubMed
41. Mathew, A, Nanoo, S. Psychosocial stressors and patterns of coping in adolescent suicide attempters. Indian J Psychol Med 2013; 35: 39–46.Google Scholar
42. Osvath, P, Vörös, V, Fekete, S. Life events and psychopathology in a group of suicide attempters. Psychopathology 2004; 37: 36–40.Google Scholar