The psychological aspects of noncardiac chest pain

摘要: Much of the early medical literature covering psychological aspects gastroesophageal reflux disease (GERD) and noncardiac chest pain (NCCP) suffers from a lack scientific rigor. Early studies were done without control groups or standardized measures for gastrointestinal (GI) disorders. Often psychiatric diagnoses made on basis subjective observations investigator as opposed to diagnosis using validated screening tools. In last 10 15 years, large number psychometric instruments have been developed use in setting. Likewise, psychophysiologic research medicine has improved by case-control studies. The ability compare normal subjects patients with origin differences between two manner is an immense improvement our investigate substrates NCCP. improvements nosology, particularly development diagnostic criteria form Diagnostic Statistical Manual American Psychiatric Association (DSM-IV), allowed better description disorders that associated NCCP, such anxiety (particularly panic disorder), major depressive disorder, somatoform Finally, GI technology, ambulatory 24-hour esophageal pH monitoring computerized motility testing, created new level precision help identify physiologic correlates various states precise accurate manner.