Relationship between anxiety level and radiological investigation. Comparison among different diagnostic imaging exams in a prospective single-center study.

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Every patient could feel anxious when he waits in a radiological department to undergo diagnostic exams. The aim of our study is to evaluate the impact of the radiological exams on patient anxiety. We evaluated 343 patients (mean age 54.83years) who underwent different types of diagnostic exams in the Department of Diagnostic Imaging at our Hospital from April 2013 to August 2014. We administered to patients the State and Trait Anxiety Inventory Test, which detected with high sensitivity both state anxiety and trait anxiety. A team of clinical psychologists and radiologists evaluated the scores obtained. 83 out of 343 patients were excluded because refused to file the questionnaire. 31% of the patients were submitted to MR, 18% to breast imaging, 10% to X-ray, 22% Computer Tomography and 19% to ultrasound, as previously described. 41% of patients were submitted to the examination because of an oncologic disease, while 59% because of non-oncological disease. Therefore, it was found that high levels of anxiety were present in most (about 91%) of the patients and the scores varied according to the imaging examination and to the examination's reason: anxiety level was higher in non-oncological patients (54%) and in patients waiting to undergo to MRI exams (29%). Our data suggest that the diagnostic exams are stressful events for the patient, also in non-oncological patients. So, it is important to adequate the radiological staff to receive the patient, to inform him and perform exams with emotive involvement with a targeted education. Also, further studies are needed to evaluate the anxiety level and the quality of the images, because the anxiety can result in a somatic disorder with hyperactivity of the autonomic nervous system which may affect the patient's physical examination, causing problems in the evaluation of radiological images making to non-cooperative patient. MRI imaging is the examination that more of all led to an anxious state of patients but the main stressor is not related to the type of diagnostic examination, but to the uncertainty of the diagnosis, therapy and prognosis.