Psychopathological Correlates of Anguish in Psychiatric Outpatients: Associations with Depression, Anxiety, and Somatic Symptoms

Introduction Anguish is an affective–somatic state characterized by intense thoracic discomfort and described by patients as pain, tightness, pressure, compression, or a “hole” in the chest. Despite its clinical frequency, its psychopathological correlates remain poorly defined. This study examined whether anguish is associated with specific symptom patterns, psychiatric comorbidities, and differential relationships with depression and anxiety. Methods A total of 100 outpatients from a large psychiatric institution in Brazil were assessed through a structured interview and allocated into three groups: with anguish, without anguish, and uncertain. Psychopathological features were evaluated using the BSI, DSQ-40, HADS, HAM-A, STAI, and MINI. Group differences and diagnostic associations were analyzed using inferential statistics. Results Patients reporting anguish displayed distinct psychopathological profiles compared with the other groups, including higher levels of somatization, fears, depressed mood, gastrointestinal complaints, and neurovegetative symptoms. Individuals with depressive disorders were 3.64 times more likely to report anguish compared with those with anxiety disorders. Conclusions Anguish appears to represent a clinically relevant affective–somatic phenomenon associated with specific symptom clusters and a stronger relationship with depression than with anxiety. These findings support the need for further investigation of anguish as a potential marker within psychiatric assessment and diagnostic formulation.