关键词: 胸痛, 焦虑, 抑郁, 危险因素

Abstract: Background　Chest pain patients are high-risk population for anxiety and depression，but the associations of anxiety and depression with coronary artery disease（CHD） and causes of chest pain have not been fully investigated.Objective　We carried out this study in order to evaluate the prevalence and associated factors of anxiety and depression in inpatients admitted for chest pain.Methods　We enrolled 358 participants from Shanghai Jiaotong University Affiliated Sixth People's Hospital from December 2016 to October 2017，including 310 consecutive patients admitted to Cardiovascular Department for chest pain（chest pain group） and 48 age- and sex-matched healthy physical examinees without self-reported chest tightness and chest pain（control group）.We collected the data concerning medical history，features of chest pain，and general characteristics（estimated by a self-developed General Questionnaire） of the chest pain patients.Generalized Anxiety Disorder 7（GAD-7） was used to evaluate anxiety，and Patient Health Questionnaire-9（PHQ-9） was applied to evaluate depression in both groups.Comparisons were performed between chest pain patients and controls，between chest pain patients with CHD and those without in terms of the prevalence of anxiety and /or depression，and between chest pain patients with anxiety and/or depression and those without regarding the features of chest pain，coronary stenosis and causes of chest pain.Multivariate Logistic regression analysis was used to determine the associated factors of anxiety and depression in chest pain patients.Results　Compared with the controls，chest pain patients were found with higher prevalence of anxiety，prevalence of depression and prevalence of anxiety and depression（P<0.05）.Chest pain patients with CHD showed lower prevalence of anxiety，prevalence of depression and prevalence of anxiety and depression than those without（P<0.05）.The duration of suffering from chest pain，the time of onset of chest pain，shortness of breath during activity，prevalence of multiple physical symptoms，the proportion of turned better by taking vasodilator drugs within 0.5 hours differed significantly between chest pain patients with anxiety and / or depression and those without（P<0.05）.Multivariate Logistic regression analysis revealed that in chest pain patients，severely stressful life experience and insufficient social support were risk factors while smoking was a protective factor for anxiety（P<0.05），prolonged duration of suffering from chest pain，multiple physical symptoms and insomnia were risk factors for depression（P<0.05）.Conclusion　Patients admitted for chest pain are at high risk of anxiety and depression.Those with at least one of the risk factors（severely stressful life experience，insufficient social support，prolonged duration，coexistence of multiple physical symptoms，insomnia） may possibly have anxiety and/or depression.

Key words: Chest pain, Anxiety, Depression, Risk factors