We studied the prevalence of anxiety and depressive disorders in patients with chest pain presenting to an emergency department. Majority of the patients had coronary artery disease (CAD). Twenty-three percent of patients with chest pain had a diagnosable psychiatric disorder according to ICD-10 research criteria. Anxiety and depressive disorders were equally distributed among patients with concomitant psychiatric syndrome. The level of psychological distress as measured on hospital anxiety and depression scale in patients of CAD with comorbid psychiatric syndrome was significantly more than patients with CAD alone and similar to non-CAD patients with psychiatric disorder. This finding is in agreement with an earlier study suggesting that the psychological distress seen in patients with CAD is related to the comorbid psychiatric condition and not to CAD.