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Detecting panic disorder in emergency department chest pain patients: A validated model to improve recognition

  • Empirical Research
  • Published:
Annals of Behavioral Medicine

Abstract

Objective

To develop and validate a detection model to improve the probability of recognizing panic disorder in patients consulting the emergency department for chest pain.

Methods

Through logistic regression analysis, demographic, self-report psychological, and pain variables were explored as factors predictive of the presence of panic disorder in 180 consecutive patients consulting an emergency department with a chief complaint of chest pain. The detection model was then prospectively validated on a sample of 212 patients recruited following the same proceduce.

Results

Panic-agoraphobia (Agoraphobia Cognitions Questionnaire, Mobility Inventory for Agoraphobia), chest pain quality (Short Form McGill Pain Questionnaire), pain loci, and gender variables were the best predictors of the presence of panic disorder. These variables correctly classified 84% of chest pain subjects in panic and non-panic disorder categories. Model properties: sensitivity 59%; specificity 93%; positive predictive power 75%; negative predictive power 87% at a panic disorder sample prevalence of 26%. The model correctly classified 73% of subjects in the validation phase.

Conclusion

The scales in this model take approximately ten minutes to complete and score. It may improve upon current physician recognition of panic disorder in patients consulting for chest pain.

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Author information

Authors and Affiliations

  1. Montreal Heart Institute, 5000 Belanger Street, H1T 1C8, Montreal, Quebec, Canada

    Richard P. Fleet, Gilles Dupuis & Denis Burelle

  2. Université du Québec à Montréal, Montreal, Canada

    Richard P. Fleet, Gilles Dupuis & André Marchand

  3. University of Missouri-Columbia, Columbia, USA

    Bernard D. Beitman

Authors
  1. Richard P. Fleet
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  2. Gilles Dupuis
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  3. André Marchand
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  4. Denis Burelle
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  5. Bernard D. Beitman
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Additional information

Preparation of this manuscript was supported in part by financial assistance from le Fonds de la recherche en santé du Québec et le Conseil québécois de recherche sociale, grant #930702-104.

The authors express their sincere gratitude to the following people for their contributions to the different aspects of this project: Lysanne Rochon-Goyer, Ph.D.; Elaine Kennedy, MPs; Lynda Bélanger, Ph.D.(C); Luce Coulombe, R.N.; Carole Trinque, Ph.D.(C); Randolph Stephenson, Ph.D.(C); Janusz Kaczorowski, Ph.D.; Daniel Millette, B.Sc. Ing; and Mrs. Christiane Lussier.

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Fleet, R.P., Dupuis, G., Marchand, A. et al. Detecting panic disorder in emergency department chest pain patients: A validated model to improve recognition. ann. behav. med. 19, 124–131 (1997). https://doi.org/10.1007/BF02883329

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