Sexual, physical, verbal/emotional abuse and unexplained chest pain.

Objectives: Approximately one third of patients with non cardiac chest pain (NCCP) report a history of abuse, however no data exists on the prevalence of abuse among people with unexplained chest pain in the general population. We aimed to determine if there is a relationship between childhood sexual, physical, emotional abuse and unexplained chest pain, and to identify whether any potential relationship is being driven by an association with psychological distress.
Methods: Subjects were identified from 2 previous random population surveys that included people with irritable bowel syndrome (IBS) and/or functional dyspepsia (FD) and healthy controls. People in the unexplained chest pain group (n=27) had chest pain in the past 12months that was not heartburn or heart disease. People in the comparison group (n=60) did not have chest pain for more than 12months. Self-reported abuse and psychological variables were assessed using validated measures.
Results: Emotional/verbal abuse (20.8% versus 4.4%, P=0.032) and physical abuse (16.7% versus 2.2%, P=0.028) were significantly more common in people with unexplained chest pain versus the comparison group. Only a history of emotional/verbal abuse was a significant independent predictor of meeting criteria for unexplained chest pain (OR=5.66; 95%CI 1.01-31.80, P=0.049) even after controlling for IBS and/or FD (OR=5.45; 95%CI 0.96-30.83, P=.05), but not when depression was controlled for (OR=4.70; 95%CI 0.90-27.61), P=0.08.
Conclusions: A history of childhood emotional/verbal abuse is a risk factor for having unexplained chest pain but the association may be moderated by psychological distress, specifically depression.
(Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.)