Long-term follow-up of psychogenic pseudosyncope

Abstract

Objective: To determine the outcome of patients with psychogenic pseudosyncope (PPS) after communication of the diagnosis.Methods: This was a retrospective cohort study of patients with PPS referred in 2007 to 2015 to a tertiary referral center for syncope. We reviewed patient records and studied attack frequency, factors affecting attack frequency, health care use, and quality of life using a questionnaire. We explored influences on attack freedom and attack frequency in the 6 months before follow-up for age, sex, education level, duration until diagnosis, probability of diagnosis, additional syncope, and acceptance of diagnosis.Results: Forty-seven of 57 patients with PPS could be traced, of whom 35 (74%) participated.Twelve (34%) were attack-free for at least 6 months. The median time from diagnosis to follow-up was 50 months (range 6-103 months). Communicating and explaining the diagnosis resulted in immediate reduction of attack frequency (p 5 0.007) from the month before diagnosis (median one attack, range 0-156) to the month after (median one attack, range 0-16). In the 6 months before follow-up, the number of admissions The 3 main groups of apparent transient loss of consciousness are syncope, epileptic seizures, and psychogenic attacks.

Psychogenic pseudosyncope: Not always a diagnosis of exclusion

“…Indeed, half of our patients with the final diagnosis of PPS had also an established (three cases) or likely (four cases) diagnosis of VVS. This finding is consistent with the study by Saal et al . where the authors found that 57% of patients with the final diagnosis of PPS also had the diagnosis of syncope.…”

Evaluating the Impact of Orthostatic Syncope and Presyncope on Quality of Life: A Systematic Review and Meta-Analysis

“…RAS attacks in young children cause fear and anxiety for both the patient and the caregiver (s), and future studies should aim to address this key knowledge gap. While our review was focused on the impact of orthostatic syncope and pre-syncope on quality of life, we recognize that other etiologies of syncope (e.g., cardiac syncope, psychogenic pseudosyncope) also have a negative impact on quality of life ( 21 , 66 ).…”

2018 ESC Guidelines for the diagnosis and management of syncope

“…Acceptance of the diagnosis by patients may be critical for therapy. In one observational study, 405 communicating and explaining the diagnosis resulted in an immediate reduction of attack frequency, with 39% of patients being asymptomatic during a mean follow-up period of 4 years. Some advice on how to inform the patient is provided in Web Practical Instructions section 10: European Society of Cardiology information sheet for patients affected by psychogenic pseudosyncope.…”