Exploring The Intersection: Depression Social Functioning and Unexplained Chest Pain in Adolescence

Background:‎ Adolescence represents a critical developmental stage marked by complex physical, emotional, and ‎social changes. Among the several health concerns encountered during this period, unexplained ‎chest pain (UCP) remains a significant issue, often leading to anxiety for both adolescents and their ‎families. While cardiac causes dominate the differential in adults, adolescent chest pain frequently ‎involves psychosomatic, functional, and psychological factors, including depression and social ‎dysfunction.‎ Aim and Objective:‎ The present study aimed to examine the association between unexplained chest pain, depression, ‎and social functioning in adolescents, and to identify contributing somatic and psychosocial factors ‎that may affect their overall well-being.‎ Materials and Methods:‎ This cross-sectional observational study was conducted over six months in the Department of ‎Paediatrics, VMKVMCH, Salem. A total of 200 adolescents aged 10–12 years presenting to the ‎pediatric OPD with unexplained chest pain were enrolled after obtaining informed consent and ‎ethical clearance. After ruling out organic causes through history, clinical examination, ECG, chest ‎X-ray, and relevant investigations, participants underwent HEADSSS assessment followed by ‎Paediatric Quality of Life Inventory (PedsQL) scoring. Adolescents with poor quality of life scores ‎were further assessed by a clinical psychologist for depression and anxiety. Data were analyzed ‎using SPSS version 29.0.‎ Results: ‎Among the 200 adolescents, a considerable proportion demonstrated significant depression and ‎impaired social functioning associated with unexplained chest pain. Additional somatic complaints ‎such as sleep disturbances, headaches, and stress factors were also commonly identified. Social ‎domains including academic performance, peer relationships, and family functioning were notably ‎affected.‎ Conclusion:‎ Unexplained chest pain in adolescents is frequently associated with depression and impaired social ‎functioning, significantly impacting their psychological well-being. Comprehensive psychosocial ‎assessments like HEADSSS and structured evaluations such as PedsQL are essential for early ‎identification and holistic management. Addressing both physical and emotional dimensions is ‎critical in improving outcomes and resilience among adolescents experiencing UCP.‎