The aim of this thesis was to investigate the long-term prognosis of chest pain patients referred to a cardiological outpatient clinic with special emphasis on the importance of panic disorder (PD).199 patients previously included in a study of psychological factors in chest pain patients were reassessed after one year by a psychiatric examination (SCID I interview and self-report questionnaires) and after nine years by both psychiatric and cardiological (including bicycle exercise test) examinations. At the baseline investigation 38% suffered from PD and 16% suffered from coronary artery disease. About 80% of eligible patients participated in the follow-up investigations. They were assessed regarding persistent PD, psychiatric morbidity, psychological distress, health related quality of life (HRQOL), treatment of PD, chest pain symptoms, mortality and non-fatal cardiac events.In summary, patients with PD at baseline reported a poor outcome regarding psychiatric morbidity, psychological distress and HRQOL and only few (10-18%) received PD treatment. The majority of patients reported persistent chest pain but they had a favorable outcome in terms of mortality and cardiac events.
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