JMIR Publications

ABSTRACT

Background:

Chest pain is a common presenting complaint among patients with coronary artery disease (CAD). Typical chest pain caused by CAD manifests as a dull ache in the central chest, which can last for several minutes (usually five to 15 minutes). It is aggravated by physical activity or emotional stress and relieved by rest. The pain can range from a dull ache to a sharp stabbing or pulling sensation. For some patients, the pain can even radiate to other body parts, such as the neck or jaw.1-2.Yet, the majority of patients with chest pain may not have any serious heart or other life - threatening conditions. Some mental illnesses, such as depression, anxiety, or somatic symptom disorder, can also induce chest tightness.These years, people of all genders could experience stress from various aspects. However, women were more likely to suffer from it. 3-4. The most common mental disorders causing chest tightness include depression, anxiety, and somatic symptom disorder. Psychological problems such as depression and anxiety have not only been associated with non - cardiac chest pain but are also independent risk factors for coronary artery disease (CAD). 5-6,Also, depression and anxiety might deteriorate coronary heart disease by triggering unhealthy lifestyles such as smoking and drinking, causing high blood pressure, and leading to hyperlipidemia. Another related mental disorder is somatic symptom disorder (SSD). It is one of the most prevalent psychological issues in many hospitals, with prevalence ranging from 5.8 to 52.9%. Patients with SSD often report somatic symptoms like chest tightness or chest pain, which could confuse many physicians in clinical practice, Especially when dealing with female patients.7-8 . In today’s stressful life, one of the most prevalent manifestations of anxiety, depression, and somatic symptom disorder can be non - cardiac tightness. Moreover, psychological problems can impair the quality of life and sense of well - being among patients with either cardiac or non - cardiac chest pain. Several studies have examined anxiety, depression, and quality of life in diverse populations. 9–10, However, there is a relative dearth of studies specifically concentrating on individuals experiencing chest pain, particularly among the female population. Due to the importance of this issue, in this study, we aimed to compare depression, anxiety, somatic symptom disorder, and quality of life in females with chest pain (cardiac and non - cardiac) and male populations in community clinics. Studying anxiety, depression, somatic symptoms, and quality of life in females will provide valuable insights into how to develop better treatments for female patients suffering from chest pain and its associated mental health issues

Objective:

This study examined the prevalence of anxiety, depression, somatic symptom disorder, and the quality of life in female patients with chest pain. This cross - sectional study was conducted from 2020 to 2022 and included participants from community hospitals across Shanghai, China. Participants were recruited through advertisements in community hospitals. All participants provided written consent to enter the study. The questionnaires were completed via face - to - face interviews. The inclusion criteria for the study were adults aged over 18 years old. Specifically, they were adults aged over 18 years old who had experienced chest pain. The exclusion criteria included musculoskeletal disorders, gastrointestinal disorders, gastroesophageal reflux disease, pulmonary disorders, heart valve disorders, and acute infectious diseases.

Methods:

An anonymous, validated short-form Mandarin questionnaire for the depression, anxiety, somatic symptom disorder, and stress survey was distributed via face-to-face interviews to 4220 patients from March 1st to July 31st, 2022, and the data were analyzed.

Results:

More than half of the surveyed patients complained of chest pain (69.38%) were females. The age distribution reveals that the majority of female patients (82.00%) fall within the elderly patients group, 13.35% were in the middle - age group, and 4.64% were in the young group.Female patients are more likely to suffer from somatic symptom disorder and stress than male patients( (12.84% vs 9.29%, p = 0.0001; 50.07% vs 36.30%, p < 0.0001, respectively). Moreover, young female patients have a higher possibility of getting depression and somatic symptom disorder compared to the other two groups (14.18% vs 4.86% vs 7.58%, p = 0.0019; 19.12% vs 8.18% vs 13.24%, p = 0.0017, respectively), and elderly female patients are more inclined to have stress than the other two groups (53.97% vs 35.04% vs 24.50%, p < 0.0001).

Conclusions:

The findings highlight the urgent need for regular screening and monitoring of female mental health status, especially for young female patients who complain of chest pain in China. Implementing targeted mental health intervention programs is essential to help female patients cope with different stressors and challenges.