Healthcare utilization and emotional distress in coronary artery disease patients

Psychosomatics. 2010 Jul-Aug;51(4):297-301. doi: 10.1176/appi.psy.51.4.297.


Background: No studies to-date have examined the various types of emotional distress (ED) for their relative power at predicting costs in patients with coronary artery disease (CAD).

Objective: The authors investigated the association between expenditure for CAD patients and various measures of emotional/psychological functioning.

Method: The authors assessed dollars spent in relation to dimensions of the Symptom Checklist 90-Revised and traditional risk factors in the year preceding referral of 164 CAD patients for stress management.

Results: Total costs were associated with the Anxiety, Phobic Anxiety, and Psychoticism scales. Hypertension was also associated with increased costs.

Conclusions: Present results indicate an association of higher costs with anxiety. Because the symptoms of anxiety overlap with those of cardiac disease, increased vigilance by both patients and practitioners, resulting in more testing and longer hospital stays is not surprising. Results suggest that there is a potential for substantial cost savings with enhanced detection and treatment of anxiety-spectrum emotional distress.

MeSH terms

  • Affective Symptoms / economics
  • Affective Symptoms / epidemiology*
  • Affective Symptoms / psychology
  • Comorbidity
  • Coronary Artery Disease / economics
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / psychology
  • Female
  • Health Care Costs / statistics & numerical data*
  • Health Services / economics
  • Health Services / statistics & numerical data*
  • Humans
  • Hypertension / economics
  • Hypertension / epidemiology
  • Hypertension / psychology
  • Male
  • Retrospective Studies
  • Risk Factors
  • Stress, Psychological / epidemiology
  • Stress, Psychological / psychology
  • Stress, Psychological / therapy