Exploring The Intersection: Depression Social Functioning and Unexplained Chest Pain in ‎Adolescence

  • Authors

    • Dr. Yedida Sravya Post Graduate Student, ‎Department of pediatrics,‎ Vinayaka mission’s Kirupananda Variyar medical college and hospitals,‎ Vinayaka mission’s Research foundation (DU), salem, Tamilnadu
    • Dr. K. Dinesh Associate professor ‎Department of pediatrics,‎ Vinayaka mission’s Kirupananda Variyar medical college and hospitals,‎ Vinayaka mission’s Research foundation (DU), salem, Tamilnadu
    • Dr. K. Rangasamy Professor and HOD Department of pediatrics,‎ Vinayaka mission’s Kirupananda Variyar medical college and hospitals,‎ Vinayaka mission’s Research foundation (DU), salem, Tamilnadu
    https://doi.org/10.14419/2we1f991

    Received date: July 18, 2025

    Accepted date: August 28, 2025

    Published date: October 11, 2025

  • Adolescence; Unexplained Chest Pain; Depression; Social Functioning; HEADSSS; Paediatric Quality ‎of Life Inventory

  • Abstract

    Background:‎ Adolescence represents a critical developmental stage marked by complex physical, emotional, and ‎social changes. Among the several health concerns encountered during this period, unexplained ‎chest pain (UCP) remains a significant issue, often leading to anxiety for both adolescents and their ‎families. While cardiac causes dominate the differential in adults, adolescent chest pain frequently ‎involves psychosomatic, functional, and psychological factors, including depression and social ‎dysfunction.‎

    Aim and Objective:‎ The present study aimed to examine the association between unexplained chest pain, depression, ‎and social functioning in adolescents, and to identify contributing somatic and psychosocial factors ‎that may affect their overall well-being.‎

    Materials and Methods:‎ This cross-sectional observational study was conducted over six months in the Department of ‎Paediatrics, VMKVMCH, Salem. A total of 200 adolescents aged 10–12 years presenting to the ‎pediatric OPD with unexplained chest pain were enrolled after obtaining informed consent and ‎ethical clearance. After ruling out organic causes through history, clinical examination, ECG, chest ‎X-ray, and relevant investigations, participants underwent HEADSSS assessment followed by ‎Paediatric Quality of Life Inventory (PedsQL) scoring. Adolescents with poor quality of life scores ‎were further assessed by a clinical psychologist for depression and anxiety. Data were analyzed ‎using SPSS version 29.0.‎

    Results: ‎Among the 200 adolescents, a considerable proportion demonstrated significant depression and ‎impaired social functioning associated with unexplained chest pain. Additional somatic complaints ‎such as sleep disturbances, headaches, and stress factors were also commonly identified. Social ‎domains including academic performance, peer relationships, and family functioning were notably ‎affected.‎

    Conclusion:‎ Unexplained chest pain in adolescents is frequently associated with depression and impaired social ‎functioning, significantly impacting their psychological well-being. Comprehensive psychosocial ‎assessments like HEADSSS and structured evaluations such as PedsQL are essential for early ‎identification and holistic management. Addressing both physical and emotional dimensions is ‎critical in improving outcomes and resilience among adolescents experiencing UCP.‎

  • References

    1. Brenner JI, Ringel RE, Berman MA. Cardiologic perspectives of chest pain in childhood: a referral problem? To whom? Pediatr Clin North Am. 1984;31:1241-1258. https://doi.org/10.1016/S0031-3955(16)34719-8.
    2. Fyfe DA, Moodie DS. Chest pain in pediatric patients presenting to a cardiac clinic. Clin Pediatr (Phila). 1984;23:321-324. https://doi.org/10.1177/000992288402300603.
    3. Lee JL, Gilleland J, Campbell RM, et al. Internalizing symptoms and functional disability in children with noncardiac chest pain and innocent heart murmurs. J Pediatr Psychol. 2013;38:255-264. https://doi.org/10.1093/jpepsy/jss111.
    4. Feinstein RA, Daniel WA Jr. Chronic chest pain in children and adolescents. Pediatr Ann. 1986;15:685-694. https://doi.org/10.3928/0090-4481-19861001-07.
    5. Loiselle KA, Lee JL, Gilleland J, et al. Factors associated with healthcare utilization among children with noncardiac chest pain and innocent heart murmurs. J Pediatr Psychol. 2012;37:817-825. https://doi.org/10.1093/jpepsy/jss055.
    6. Proulx AM, Zryd TW. Costochondritis: diagnosis and treatment. Am Fam Physician. 2009; 80: 617-620.
    7. Sabri MR, Ghavanini AA, Haghighat M, Imanieh MH. Chest pain in children and adolescent: epigastric tenderness as a guide to reduce unnecessary work-up.
    8. Psychosocial assessment tools for children and young people aged 5–18 years: A rapid review of the literature.
    9. Karen McLean, Elodie O'Connor, Rachel Ong, Corey Joseph, Rachel Skinner.
    10. 1860 Raising our heeadsss– a review of the use and documentation of an adolescent psychosocial risk assessment instrument in an Irish university teaching hospital Miriam Smyth1, Emma Gordon2.
    11. Perception of health related quality of life in healthy Indian adolescentsDinesh Kamaraj, Elayaraja Sivaprakasam*, Latha Ravichandran, Umapathy Pasupathy.
    12. Eliacik K, Bolat N, Kanik A, Malas N, Demircan T, Hortu H, Özyurt G, Orbatu D, Alaygut D, Guven B. Adolescents with unexplained chest pain reported depression and impaired emotional and social functioning. Acta Paediatr. 2020 Aug;109(8):1642-1648. PMID: 31860731. https://doi.org/10.1111/apa.15144.
    13. Fagring AJ, Gaston-Johansson F, Kjellgren KI, Welin C. Unexplained chest pain in relation to psychosocial factors and health-related quality of life in men and women. Eur J Cardiovasc Nurs. 2007 Dec;6(4):329-36. Epub 2007 Jun 19. PMID: 17581792. https://doi.org/10.1016/j.ejcnurse.2007.05.001.
    14. Baune BT, Caniato RN, Garcia-Alcaraz MA, Berger K. Combined effects of major depression, pain and somatic disorders on general functioning in the general adult population. Pain. 2008 Aug 31;138(2):310-317. Epub 2008 Feb 6. PMID: 18258371. https://doi.org/10.1016/j.pain.2008.01.002.
    15. Tyrer P, Tyrer H, Cooper S, Barrett B, Kings S, Lazarevic V, Bransby-Adams K, Whittamore K, Walker G, McNulty A, Donaldson E, Midgley L, McCoy S, Evered R, Yang M, Guo B, Lisseman-Stones Y, Doukani A, Mulder R, Morriss R, Crawford M. Cognitive behaviour therapy for non-cardiac pain in the chest (COPIC): a multicentre randomized controlled trial with economic evaluation. BMC Psychol. 2015 Nov 24; 3: 41. PMID: 26596540; PMCID: PMC4657319. https://doi.org/10.1186/s40359-015-0099-7.
    16. Tomaszek L, Dębska G, Cepuch G, Kulpa M, Pawlik L, Broniatowska E. Evaluation of quality of life predictors in adolescents and young adults with cystic fibrosis. Heart Lung. 2019 Mar-Apr;48(2):159-165. Epub 2018 Oct 10. PMID: 30316456. https://doi.org/10.1016/j.hrtlng.2018.08.003.
    17. Yap AU, Chua EK, Dworkin SF, Tan HH, Tan KB. Multiple pains and psychosocial functioning/psychologic distress in TMD patients. Int J Prostho-dont. 2002 Sep-Oct;15(5):461-6. PMID: 12375461.

  • Downloads

  • How to Cite

    Sravya , D. Y. ., Dinesh, D. K. ., & Rangasamy , D. K. . (2025). Exploring The Intersection: Depression Social Functioning and Unexplained Chest Pain in ‎Adolescence. International Journal of Basic and Applied Sciences, 14(6), 182-187. https://doi.org/10.14419/2we1f991