Panic-like anxiety ( panic attacks with or without panic disorder), a highly treatable condition, is the most prevalent condition associated with unexplained chest pain in the emergency department. Panic-like anxiety may be responsible for a significant portion of the negative consequences of unexplained chest pain, such as functional limitations and chronicity. However, more than 92% of panic-like anxiety cases remain undiagnosed at the time of discharge from the emergency department. The 4-item Panic Screening Score questionnaire was derived in order to increase the identification of panic-like anxiety in emergency department patients with unexplained chest pain.

The goals of this prospective cohort study are to (1) refine the Panic Screening Score; (2) validate the revised version of the Panic Screening Score; (3) measure the reliability of the revised version of the Panic Screening Score and (4) assess the acceptability of the instrument among emergency physicians.

Inclusion Criteria:

Presenting unexplained chest pain as defined by:

• the absence of an identifiable cause (e.g., pneumothorax,pneumonia),
• the absence of chest trauma,
• the absence of new malignant cardiac arrhythmia, and
• a score of 2 or less on the modified version of the thrombolysis in myocardial infarction score.

Exclusion Criteria:

• presence of a terminal illness;
• presence of a severe communication problem that could interfere with the administration of the questionnaire;
• presence of a psychotic state, a major cognitive deficit or other condition that could invalidate the interview;
• being legally incompetent.

Patients in the emergency department