Evidence map›Paper›PMID 40781746›Full record

ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2026

Psychological Comorbidity in Patients Presenting to the Emergency Department With Low-Risk Chest Pain and Anxiety.

Linh Dang, Kurt Kroenke, Jill Connors, Timothy E Stump, Patrick O Monahan, Yelena Chernyak, Emily Holmes, Colin Hoffman, Kevin Prather, Paul I Musey

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04811521 (Patient-centered Treatment of Anxiety After Low-Risk Chest Pain in the Emergency Room), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04811521 naunknown statusnot on this map

Patient-centered Treatment of Anxiety After Low-Risk Chest Pain in the Emergency Room

TypeinterventionalSponsorIndiana UniversityRan2021 to 2025Enrolled375ConditionsGeneralized Anxiety Disorder, Chest Pain, PanicArmsPrimary care follow-up, Online Self-Administered Anxiety Management Program plus Peer Support Guidance, Therapist-Administered Cognitive Behavioral Therapy
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Psychological Comorbidity in Patients Presenting to the Emergency Department With Low-Risk Chest Pain and Anxiety.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Linh DangIndiana University School of Medicine, Indianapolis, Indiana, USA.ORCID 0009-0004-7744-2752
Kurt KroenkeDepartment of Medicine, Indiana University School of Medicine and Regenstrief Institute, Indianapolis, Indiana, USA.ORCID 0000-0002-0114-4669
Jill ConnorsDepartment of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Timothy E StumpDepartment of Biostatistics and Health Data Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Patrick O MonahanDepartment of Biostatistics and Health Data Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Yelena ChernyakDepartment of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Emily HolmesDepartment of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Colin HoffmanDepartment of Biostatistics and Health Data Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA.ORCID 0009-0009-9229-5865
Kevin PratherDepartment of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.ORCID 0000-0002-8299-9991
Paul I MuseyDepartment of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.ORCID 0000-0002-5693-190X

Funding

Patient-Centered Outcomes Research Institute CER2019C3-17869
6 · The paper itself

Abstract

objectiveLow-risk chest pain (LRCP) is one of the most common conditions presenting in the emergency department (ED) and is strongly associated with anxiety. The purpose of this study is to determine the prevalence of other psychological comorbidities and clinical factors associated with severe anxiety in LRCP.

methodsBaseline data is analyzed from the PACER trial comparing the effectiveness of two telehealth interventions for LRCP patients with anxiety. Key eligibility criteria are a HEART score < 7 and either a GAD-7 anxiety score ≥ 8 or a positive PHQ screener for panic disorder. Psychological comorbidity measures included the Patient Health Questionnaire 8-item (PHQ-8) depression scale, the PHQ-14 somatization scale, the Primary Care Posttraumatic Stress Disorder Screen, the Sheehan Disability Scale, and the General Self-Efficacy Scale. Multivariable modeling is used to determine factors associated with severe anxiety.

resultsThe 375 patients had a mean age of 39.9; 70.9% were women; 62.9% were White, 32.6% Black, and 4.5% other race. The majority (75%) screened positive for panic disorder, and 42% of participants had severe anxiety (GAD-7 ≥ 15). Non-anxiety psychological comorbidity was very high; the proportion of patients exceeding scale cut points was 58% for depression, 57% for PTSD, 52% for somatization, 59% for high disability, and 31% for low self-efficacy; each was significantly associated with severe anxiety on univariable analysis. Four patient characteristics were independently associated with severe anxiety in multivariable models: odds ratios (95% CI) were 2.7 (1.5-4.9) for depression, 2.3 (1.4-3.9) for low self-efficacy, 2.1 (1.2-3.6) for low education (high school or less), and 1.8 (1.0 to 3.3) for female sex.

conclusionsLRCP is accompanied not only by anxiety but also by other potentially treatable psychological comorbidities Severe anxiety is more common in individuals with depression, low self-efficacy, lower education, and possibly women. TRAIL REGISTRATION: PACER is registered in clinicaltrials.gov identifier: NCT04811521.

Indexed as

AnxietyChest PainEmergency Service, HospitalAdultComorbidityFemaleHumansMaleMiddle AgedMulticenter Studies as TopicPanic DisorderPrevalenceRandomized Controlled Trials as TopicSurveys and QuestionnairesTelemedicineanxietychest paindepressionemergency medicinenoncardiacpanic

Identifiers

PMID40781746
PMCPMC12828106

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.