Self-perception and anger with chest pain without cardiac etiology

Objective: Physical symptoms are the most common expressions of social problems and emotional inconvenience. This problem is usually medically unexplained in patients with chest pain. 'Chest Pain without Cardiac Etiology' is diagnosed in more than fifty percent of patients with chest pain. Anger and suppressed hostility are important factors the development of somatic symptoms. It is important to point out that somatization in depressive disorders is due to expression of anger while somatization in anxiety is due to anger suppression. It is known that, while patients with chronic pain experience anger, they do not care enough to express it because they are in denial of this situation. The form of anger expression in patients with chronic pain may be effective in the disease process and is one of the subjects to be emphasized. Suppression of intense anger leads to the development of chronic pain and suppressed anger scores are higher than healthy controls. In this study, we compared patients with chest pain without detected cardiac etiology and healthy controls in terms of anger and self perception.

Methods: Twenty five patients were included in the study. They all presented to the cardiology clinic with complaints of chest pain, but did not have any detected cardiac etiology. The healthy control group of 80 persons was organized by matching them with the patients according to their age, gender, and education. The Socio-demographical data collection form, Multidimensional Anger Scale, and Social Comparison Scale were given to both of the groups.

Results: There was no significant difference between the socio-demographic features of the two groups. The non-cardiac chest pain group scored higher on the Social Comparison Scale. The healthy control group scored higher on calm behaviour and nonchalant response. Revenge for the reaction and inward looking responses were significantly higher in the non-cardiac chest pain group.

Conclusions: The non-cardiac chest pain group had more negative perception of self as compared to healthy individuals, further they were found to be more negative in their forms of expressing anger. Repressed anger and hostility are important factors in the development of chronic pain. Work on the relationship between mind and body has been a topic of interest in recent years. Not just how an individual perceives himself, but also how other people perceive and relate to him, probably effects the physiological system of that individual.

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