Paraverbal speech stylistics in patients with chest pain and normal coronary angiography: is this method helpful in diagnosing underlying pathology?

Journal of Clinical and Basic Cardiology 1998; 1 (1): 25-29

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Keywords: Angina pectoris,  Panikattacke,  Sprachstil,  Syndrom X,  Angina pectoris,  panic disease,  speech stylistics,  syndrome X

The aim of this study was to establish whether an analysis of speech stylistics proves useful in identifying subjects with angina pectoris-like chest pain and syndrome-X (SYX) or panic disease (PD). We studied 32 patients, 16 of them suffering from PD, and 16 having SYX. The two groups consisted of women and men, 8/8 from each sex, and were aged 58.6 ± 10.8 years (mean ± SD) and 59.8 ± 9.6, for PD and SYX, respectively. All patients suffered from angina pectoris (AP) and had a normal coronary angiography before this study. Whereas SYX patients had positive exercise testing (showing stress-induced ischaemia), patients suffering from PD had normal exercise testing and fulfilled the criteria for PD, anamnestically and in specially developed questionnaires. All patients were interviewed using a semi-structured non-stress interview. In addition, 20 of them were interviewed in a stress-type interview thereafter. Speech stylistics were assessed during patients? speech sequences where they described pain and others where they spoke about non-conflict contents. To determine speech stylistics we used the method developed by ourselves and published elsewhere. The speech analysis was performed in a blinded manner as was the group allocation. The basal movement for the two groups differed in systolic blood pressure (129.0 ± 13.6 mm Hg (mean ± SD), vs. 117.5 ± 31.8 mm Hg, (p<0.05) for PD and SYX respectively), and disease duration (3.3 ± 1.4 years, vs. 2.4 ± 1.2 years (p= NS) for PD and SYX, respectively). In non-stress interviews, PD patients showed a significantly lower speed of speech, in both pain and non-pain sections (200.4 ± 33.1 syllables/min vs. 208.3 ± 23.1 syllables/min for pain (p<0.05) in PD and SYX, respectively; and 202.8 ± 36.9 syllables/min vs. 217.3 ± 32.2 syllables/min for non-pain sections (p<0.001) in PD and SYX, respectively). Similar significant differences were observed in pain and non-pain sections for plosive words, repeated words, and silence latency. In simultaneous speech, only the PD group showed differences between pain and no-pain sections. No differences were noted in uneven speed of speech, speed volume, and swallowed words. Group differences were more prominent during stress-interviews in pain and non-pain sections for speed of speech, plosive words, and repeated words. Swallowed words differed only in non-pain sections. The proposed method seems useful to differentiate between several verbal contents and their related emotive involvement as well as to identify patients without PD suffering from angina pectoris-like chest pain (= SYX). J Clin Bas Cardiol 1998; 1: 25-9.