Abstract
BACKGROUND/OBJECTIVES: This study aimed to investigate the internalizing characteristics, including anxiety and depressive symptoms, in adolescents presenting with non-cardiac chest pain (NCCP), and to explore the effects of sociodemographic variables and prior psychosocial experiences on psychological distress. METHODS: This cross-sectional study was conducted in Turkey and included 128 adolescents aged 10-18 years (57.0% female, 43.0% male) who presented to pediatric cardiology or general pediatric outpatient clinics. The Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAI-C), Screen for Child Anxiety Related Emotional Disorders (SCARED), Brief Symptom Inventory (BSI), and the Social Support Appraisals Scale for Children (SSAS-C). Sociodemographic variables and prior psychosocial symptom history were also recorded. RESULTS: Adolescents with non-cardiac chest pain exhibited elevated anxiety and psychological distress compared to controls. Female participants demonstrated higher levels of stress, anxiety, and overall psychological symptom burden than males. Higher maternal age was associated with lower perceived stress, while a prior history of psychosocial symptoms was linked to increased anxiety and global psychological distress. Participants with a history of psychosocial symptoms had higher anxiety (p = 0.027) and BSI (p = 0.004) scores. Significant positive correlations were found between anxiety, depression, obsessive-compulsive symptoms, and the BSI total score (r values ranging from 0.718 to 0.892). CONCLUSIONS: Adolescents with NCCP exhibit significant internalizing symptoms, particularly anxiety and depression. Female gender and prior psychosocial stressors were associated with elevated symptom scores. Maternal age may have a buffering effect on adolescent stress levels. These findings underscore the importance of integrating psychological screening into the evaluation of chest pain in adolescents to enable early identification and intervention.