Clinical correlates of thoracic anguish in patients with depression and anxiety

Background : In this study, anguish is defined as a negative affective state characterized by intense thoracic discomfort, described by patients as sensations of pain, tightness, pressure, a “hole,” or compression in the chest. Objectives : This study examined whether anguish contributes to the psychopathological profile of psychiatric patients by identifying associated symptoms and comorbidities, and by assessing its relationship with diagnoses of depression and anxiety. Methods : A total of 100 outpatients from a large psychiatric institution in Brazil were evaluated and classified into three groups based on a structured interview assessing the presence of anguish: with anguish, without anguish, and uncertain. Psychopathology was assessed using the BSI, DSQ-40, HADS, HAM-A, STAI, and MINI. Results : Individuals reporting anguish showed significant differences in symptom patterns and comorbidities compared to the other groups. The anguish group presented higher levels of somatization, fears, depressed mood, gastrointestinal complaints, and neurovegetative symptoms. Inferential analyses further indicated that patients with depression were 3.64 times more likely to report anguish compared to those with anxiety. Conclusions : The findings suggest that the subjective experience of anguish may have clinical relevance within psychiatric assessment. The association with specific symptom clusters and its stronger relationship with depression highlight the potential value of further investigating anguish as a meaningful affective–somatic phenomenon in psychiatric practice.