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Laederach-Hofmann K et al.  
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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Fig. 1: Sprache und Brustschmerz

Keywords: Angina pectorisPanikattackeSprachstilSyndrom XAngina pectorispanic diseasespeech stylisticssyndrome 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.
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