A 30-year-old woman complains of pain in the heart area ("aching, piercing pain") that arises primarily in the morning hours in autumn and spring. Pain irradiates into the neck, back, abdomen and is attended by rapid heart rate and low vital tonus. This condition occurs independently from physical exertion. In the evening her condition improves. Somatic and neurologic state and ECG have no pathologies. What pathology is likely to result in such clinical presentation?

Answer options

1. Somatized depression
2. Somatoform autonomic dysfunction
3. Hypochondriacal depression
4. Rest angina pectoris
5. Pseudoneurotic schizophrenia

Explanation

The main task is to differentiate the etiological cause of cardiac complaints. There are no objective data in favor of the cardiac cause of the existing symptoms. At the same time, there is a clear indication of the seasonality changes and daily fluctuation in the intensity of her complaints. All the above, allows us to conclude that the problem presents a clinical picture of somatized depression. In favor of this diagnosis, the patient has somatic cardiac complaints, diurnal and seasonal dynamics characteristic of depression, and the absence of objective data in favor of somatic or neurological pathology. Psychiatry: [Textbook] V.L. Gavenko, V.M. Sinayko, G.A. Samardakova and others; reduction by V.L. Gavenko, – Kharkov: Region-inform, 2006. – 286 – 290 P.