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Cited by 73Psychosomatic Disorders and Their TreatmentsCardiac Health and Mental HealthAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Psychiatric disorders in medical outpatients complaining of palpitations

Barsky, Arthur J., Cleary, Paul D., Coeytaux, Remy R., Ruskin, Jeremy N.·1994·Journal of General Internal Medicine
DOI 10.1007/bf02599176
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Abstract

Objective To determine the prevalence of psychiatric disorders in ambulatory patients undergoing Holter monitoring to evaluate palpitations.Design Patients referred for 24-hour ambulatory electrocardiographic (ECG) monitoring were studied with a structured diagnostic interview and self-report questionnaires prior to monitoring.Setting Holter laboratory of a large academic medical center.Patients and other participants One hundred forty-five consecutive patients complaining of palpitations and 70 asymptomatic non-patient volunteers.Outcome measures DSM-III-R psychiatric diagnoses.Results Forty-five percent (44.8%) of the participants had at least one lifetime anxiety or depressive disorder and 24.8% had at least one current (one month) disorder. The lifetime prevalence of panic disorder was 27.6%, and that of major depression was 20.8%. Current prevalence rates showed a similar pattern; the current prevalence of panic disorder was 18.6%. Panic disorder and somatization disorder symptoms were significantly more prevalent in the palpitation group than in the general medical clinic at the same hospital. Patients with a psychiatric diagnosis were more likely to report cardiac symptoms during monitoring than were those without psychiatric disorder, and more commonly described their symptoms as "pounding" and reported faintness, lightheadedness, and vertigo. Although cardiac histories and ECG results were no more serious, the patients with psychiatric diagnoses rated their overall health status as significantly worse.Conclusions Almost half of palpitation patients referred for Holter monitoring have a psychiatric disorder. More than a fourth have lifetime panic disorder and a fifth have had panic attacks in the month before monitoring.

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Crossref · 10.1007/bf02599176

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  • Psychosomatic disorders most frequently associated with palpitations include anxiety, panic attacks, depression, and somatization, which can either induce sinus tachycardia or modify the patient's subjective perception of a heartbeat that is otherwise normal or presents minimal irregularities.

    “Psychosomatic disorders that are most frequently associated with palpitations include anxiety, panic attacks, depression, and somatization, which can either induce sinus tachycardia or modify the patient's subjective perception of a heartbeat that is otherwise normal or presents minimal irregularities.20 -23”

    From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [21]

  • According to case records, the prevalence of anxiety syndrome and panic attacks in patients with palpitations ranges from 15% to 31%.

    “According to the case records, the prevalence of anxiety syndrome and panic attacks in patients with palpitations ranges from 15% to 31%.20 -22”

    From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [21]

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Authors
Barsky, A. J., Cleary, P. D., Coeytaux, R. R., & Ruskin, J. N.
Affiliations
  • Harvard University (US)
  • Massachusetts General Hospital (US)
ORCID
Venue
Journal of General Internal Medicine
Publisher
Springer Science and Business Media LLC
Published
1994-06
Volume
9
Issue
6
Pages
306-313
ISSN
  • 0884-8734 (ISSN-L)
  • 1525-1497
DOI
10.1007/bf02599176
OpenAlex
W1969755793
Cited by
73
References
48
Citations by year
2025: 2 · 2024: 3 · 2023: 2 · 2022: 5 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 5 · 2016: 2 · 2015: 2 · 2014: 2 · 2013: 3 · 2012: 4
FWCI
1.82
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Journal of General Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01hl043216-08)
  • National Heart, Lung, and Blood Institute (HL 43216)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
palpitations, psychiatric comorbidity, panic disorder, major depressive disorder, anxiety disorders, somatization, Holter monitoring, cardiac symptoms, health status, prevalence
MeSH terms
Adult, Anxiety Disorders, Mental Disorders, Depressive Disorder, Female, Heart Rate, Humans, Male, Middle Aged, Outpatients, Somatoform Disorders, Electrocardiography, Ambulatory, Prevalence, Panic Disorder

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