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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: kayieliacik@gmail.com
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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
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Copyright
© Cambridge University Press 2016 

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