SciELO - Scientific Electronic Library Online

vol.36 suppl.3Prevalence of depression in older women with hip fractureDepression and myocardial infarction author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Archives of Clinical Psychiatry (São Paulo)

Print version ISSN 0101-6083


FRAGUAS, Renério et al. Major depression in patients with non-cardiac chest pain: Who is going to treat?. Rev. psiquiatr. clín. [online]. 2009, vol.36, suppl.3, pp.83-87. ISSN 0101-6083.

OBJECTIVE: To investigate the presence of psychiatric disorders in patients with chest pain not responsive to treatment. METHOD: We evaluated 18 patients judged by their physicians to have a chest pain not responsive to usual treatment, which included anti-pain medicines and investigation and treatment of possible etiological causes such as coronary artery disease, and gastroesophageal reflux disease. A psychiatrist interviewed the patients using the Present State Examination and made the diagnosis based on the DSM-III-R criteria. Current major depression was diagnosed in 6 (30%) patients, somatization in 1 (6%) and panic disorder in 1 (6%) patient. Seven patients were receiving tricyclics antidepressant with doses > 75 mg/day. DISCUSSION: Patients were receiving doses of tricyclics antidepressants efficacious for pain but not for major depression. It is possible that the low dose of antidepressants used to treat pain may partially ameliorate depressive symptoms, making the appropriate diagnosis and treatment of major depression even more difficult, consequently contributing to the persistence of pain and other complains. Considering the wide alternatives to effectively treat depression, a focus on detection and treatment of major depression in patients with chest pain is warranted by clinicians and researchers.

Keywords : Depression; cardiology; pain; treatment; primary care.

        · abstract in Portuguese     · text in Portuguese     · Portuguese ( pdf epdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License