Psychological responses to episodic chest pain

Patients with chronic musculo-skeletal pain have been profiled as "dysfunctional", "interpersonally distressed" or "adaptive copers". The relevance of these for episodic visceral pain is unknown. Our aim was to replicate conceptually the taxonomy in patients with episodic visceral pain. Patients with chest pain and gastro-esophageal reflux disease (GERD; n=25), coronary artery (CAD; n=20), or with chest pain but without either reflux or coronary artery disease (non-cardiac chest pain--NCCP; n=23) were assessed using several standard affective and cognitive measures relevant to pain. Differences between the diagnostic groups were explored. K-means cluster analysis broadly replicated the three groups found in previous research but the "interpersonally distressed" group had few members. An additional cluster analysis suggested a more parsimonious solution for the sample was a two-cluster one, which approximated to the "adaptive coper" and "dysfunctional" profiles. Membership of both the three- and two-cluster profiles was not associated with membership of specific diagnostic category.