Somatic symptoms and their association with anxiety and depression in Chinese patients with cardiac neurosis

Objective We sought to investigate somatic symptoms detected by the Somatic Self-rating Scale and to evaluate whether they were associated with the psychological symptoms of anxiety and depression in patients with cardiac neurosis. Methods A total of 180 patients with cardiac neurosis at the Third Xiangya Hospital, Changsha, China, were surveyed from January 2017 to July 2018. Participants completed a general information questionnaire, the Somatic Self-rating Scale, the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder Scale-7. Results The mean (±standard deviation) somatic symptom score in patients with cardiac neurosis was 40.83 ± 7.12. The most severe symptoms were cardiovascular symptoms, fatigue and muscle soreness. A total of 90 patients (46.4%) had anxiety and 80 (50.0%) had depression. Multiple stepwise regression analysis showed that somatic symptoms in patients with cardiac neurosis were associated with both anxiety and depression. Conclusion Somatic symptoms in patients with cardiac neurosis were associated with both anxiety and depression. Therefore, it is important to provide effective emotional interventions to promote patient rehabilitation.

On Cardiac Neurosis in Children

In this paper, Winnicott revisits his early work on cardiac neurosis in children based on his experience of running the London Rheumatic Clinic between the wars. He states that the key to good clinical sense in the diagnosis of rheumatism was to take a full history and give a physical examination. In positive diagnoses, the child’s activity would be restricted, but in around half of the cases the child could be diagnosed as non-choreic and therefore not liable to heart disease, thus allowing the doctor to manage child’s difficulties without restricting his or her activity. Winnicott states that this is where psychiatry gives a definite and positive diagnostic contribution, when the symptomatology can be accounted for in terms of the child’s normal variables due to his personality and emotional development.