Abstract: Objective · To explore the role of psychological problems of somatization, anxiety, and depression in patients presenting chest pain who underwent coronary angiography (CAG). Methods · Altogether, 908 patients with chest pain referred to the cardiology inpatient department were enrolled in the present study. The enrolled patients underwent CAG and coronary angiographic results were classified into negative (<30% diameter stenosis in all vessels), mild to moderate coronary stenosis ( ≥ 30% and <75% diameter stenosis in all vessels) and severe coronary stenosis group ( ≥ 75% diameter stenosis in at least a single vessel). Patients also completed a battery of self-reported inventories before the CAG: the Self-Rating Somatic Symptom Scale (SSS), the Generalized Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9). Results · Compared with severe coronary stenosis group, male patients in the mild to moderate coronary stenosis group (n189) seemed to have higher rate of somatization (20.6% vs 18.5%, P0.014), higher rate of depression (20.6% vs 10.6%, P0.008), and higher rate of anxiety (13.4% vs 6.6%, P0.028). Compared with severe coronary stenosis group, female patients in the mild to moderate coronary stenosis group seemed to have higher rate of somatization (57.6% vs 39.4%, P0.008). Conclusion · The positive rate of somatization symptoms in patients with mild to moderate coronary stenosis was higher than that in patients with severe coronary stenosis. These findings suggest that psychological problems may contribute in part to the development of chest pain and other physical symptoms. It is also needed to evaluate the clinical and economic benefits of early psychological interventions, especially in mild to moderate coronary stenosis patients who are presenting chest pain.

Key words: chest pain, coronary angiography, somatization disorder, anxiety, depression