Background: Patients with non-cardiac chest pain (NCCP) suffer from recurrent chest pain and use a substantial amount of healthcare resources.

Objective: To explore the prevalence of depressive symptoms, cardiac anxiety and fear of body sensations in patients discharged with a NCCP diagnosis. Additionally, to explore how depressive symptoms, cardiac anxiety and fear of body sensations are related to each other and to healthcare seeking behaviour.

Methods: Cross-sectional descriptive design. Data were collected from 552 patients diagnosed with NCCP in four Swedish hospitals within one month from discharge using the Patient Health Questionnaire-9, Cardiac Anxiety Questionnaire and Body Sensations Questionnaire. Healthcare seeking behaviour the year before study inclusion (i.e. the number of healthcare contacts) was self-reported by the patients.

Results: Of the study population, 141 (26 %) reported at least moderate depressive symptoms, 229 (42 %) reported at least moderate cardiac anxiety, and 337 (62 %) reported some degree of fear of body sensations. There were strong positive relationships between depressive symptoms and cardiac anxiety (r_s=.49, p<.01), depressive symptoms and fear of body sensations (r_s=.50, p<.01), and cardiac anxiety and fear of body sensations (r_s=.56, p<.01). 26 % of the study participants reported 2-3 healthcare contacts and 14 % reported more than 3 healthcare contacts due to chest pain. In a multivariable regression analysis, and after adjusting for multi-morbidity, cardiac anxiety was the only variable independently associated with healthcare seeking behaviour.

Conclusions: Symptoms of psychological distress were more frequently reported by the patients with NCCP that had more healthcare contacts. Cardiac anxiety had the strongest relationship with healthcare seeking behaviour, and may therefore be an important target for intervention. The results from this study will guide the development of a web-based intervention targeting cardiac anxiety to improve patient outcomes and reduce healthcare use and costs.