Consecutive patients seen in the first-heart-aid service of a university hospital and given a diagnosis of noncardiac chest pain completed the self-report Hospital Anxiety and Depression Scale. Patients with a score >or=8 on either the anxiety or depression subscale (N=266, mean age=55.81 years, SD=13.03, 143 male patients) were compared with patients scoring <8 (N=78, mean age=60.55 years, SD=10. 84, 50 male patients) by means of the Mini International Neuropsychiatric Interview. Panic disorder and/or depression identified by the diagnostic interview were highly prevalent in the group with a score >or=8 (73.3% versus 3.9% in the comparison group). The Hospital Anxiety and Depression Scale is an adequate screening instrument for the detection of affective disorders in patients with noncardiac chest pain.