Minority Health Archive

Association of a Culturally Defined Syndrome (Nervios) with Chest Pain and DSM-IV Affective Disorders in Hispanic Patients Referred for Cardiac Stress Testing

Pavlik, Valory N. and Hyman, David J. and Wendt, Juliet A. and Orengo, Claudia (2004) Association of a Culturally Defined Syndrome (Nervios) with Chest Pain and DSM-IV Affective Disorders in Hispanic Patients Referred for Cardiac Stress Testing. Ethnicity & Disease, 14 (4). pp. 505-514. ISSN 1049-510X

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Abstract

Background: Hispanics have a high prevalence of cardiovascular risk factors, most notably type 2 diabetes. However, in a large public hospital in Houston, Texas, Hispanic patients referred for cardiac stress testing were significantly more likely to have normal test results than were Whites or non-Hispanic Blacks. We undertook an exploratory study to determine if nervios, a culturally based syndrome that shares similarities with both panic disorder and anginal symptoms, is sufficiently prevalent among Hispanics referred for cardiac testing to be considered as a possible explanation for the high probability of a normal test result. Methods: Hispanic patients were recruited consecutively when they presented for a cardiac stress test. A bilingual interviewer administered a brief medical history, the Rose Angina Questionnaire (RAQ), a questionnaire to assess a history of nervios and associated symptoms, and the PRIME-MD, a validated brief questionnaire to diagnose DSM-IV defined affective disorders. Results: The average age of the 114 participants (38 men and 76 women) was 57 years, and the average educational attainment was 7 years. Overall, 50% of participants reported a history of chronic nervios, and 14% reported an acute subtype known as ataque de nervios. Only 2% of patients had DSM-IV de®ned panic disorder, and 59% of patients had a positive RAQ score (ie, Rose questionnaire angina). The acute subtype, ataque de nervios, but not chronic nervios, was related to an increased probability of having Rose questionnaire angina (P5.006). Adjusted for covariates, a positive history of chronic nervios, but not Rose questionnaire angina, was signi®cantly associated with a normal cardiac test result (OR52.97, P5.04). Conclusion: Nervios is common among Hispanics with symptoms of cardiac disease. Additional research is needed to understand how nervios symptoms differ from chest pain in Hispanics and the role of nervios in referral for cardiac workup by primary care providers and emergency room personnel.


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Item Type: Article
Additional Information: After clicking link, scroll down the page to find the article. This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions.
Uncontrolled Keywords: Chest Pain; Nervios; Cardiovascular Disease; DSM-IV Affective Disorder
Subjects: Health > Public Health > Chronic Illness & Diseases > Cardiovascular Disease
Health > Public Health > Chronic Illness & Diseases > Diabetes
Health > Public Health > Health Risk Factors
Research
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Depositing User: Users 141 not found.
Date Deposited: 07 Dec 2008
Last Modified: 24 Jun 2011 12:24
Link to this item (URI): http://health-equity.lib.umd.edu/id/eprint/1180

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