Comparison of Anxiety in Children with Non-cardiac Chest Pain and a Control Group

Abstract

Background: Chest pain is a common reason for pediatric visits to cardiologists and is often associated with non-cardiac disorders. In children and adolescents, heightened anxiety levels are frequently linked to experiences of non-cardiac chest pain. Objectives: The present study aims to evaluate the relationship between non-cardiac chest pain and anxiety levels in children and adolescents. Methods: A case-control analytical study was conducted on 62 children aged 8 to 15 years with non-cardiac chest pain, compared to a control group of 62 healthy peers. Participants completed the Spence Children’s Anxiety Scale (SCAS) to assess anxiety levels. Statistical analysis was performed using SPSS, employing independent t-tests and Mann-Whitney tests. Results: The mean total anxiety score for children with non-cardiac chest pain was significantly higher (45.81) than that of the control group (23.44, P < 0.001). Subscale analyses revealed elevated scores in the case group across various anxiety dimensions: Panic/agoraphobia (6.94 vs. 3.71), separation anxiety (8.69 vs. 4.42), and generalized anxiety (8.44 vs. 4.53). Boys with chest pain had a total anxiety score of 45.93 compared to 22.33 in controls (P < 0.001), while girls scored 45.69 versus 24.47 (P < 0.001). Notably, children aged 8 to 12 showed the highest anxiety levels (48.00 vs. 22.34, P < 0.001). For older children (13 - 15 years), the total anxiety score was 40.44 versus 26.87 (P = 0.008), with significant differences in separation anxiety (6.61 vs. 4.20, P = 0.022) and obsessive-compulsive behaviors (8.17 vs. 3.93, P = 0.002). Conclusions: This study highlighted the significant association between non-cardiac chest pain and heightened anxiety levels in children and adolescents. These findings emphasize the importance of integrating psychological assessments in the evaluation of pediatric patients presenting with chest pain to enhance management strategies and support for affected families.