Psychiatric and medical co-morbidity in mitral valve prolapse

Abstract

Objective: Significant controversy continues to exist in the empirical literature regarding the diagnosis and treatment of mitral valve prolapse (MVP). In addition, there is also inconsistency in the correlation of anxiety disorders as co-existing with MVP, as well as cause and effect issues in terms of the role of the autonomic nervous system, MVP and panic attacks. Recent studies suggest that the co-morbidity of an anxiety disorder and clinical depression appears to increase the likelihood of MVP in predisposed patients. The objective of this review was to examine, clarify, and further define the medical and psychiatric aspects of MVP.Methods: A literature review was conducted on empirical studies and reviews examining MVP.Results: It was found that although MVP is highly correlated with psychiatric disorders, the lack of adequate control groups and clear criteria for a diagnosis of MVP in most empirical studies examining these associations make it difficult to determine the relationship between MVP and psychiatric disorders.Conclusions: Suggestions for further research in the areas of depression and personality characteristics are offered. It is also suggested that the use of control groups from populations with cardiac disorders and a better definition of MVP will clarify many of the problems in empirical studies aiming to determine the relationship between MVP and psychiatric disorders.

The Methodology of Syndrome Analysis within the Paradigm of "Qualitative Research in Clinical Psychology"

“…These considerations justify the high social importance attached to MVP. Other relevant facts include the following: a pronounced dissociation between numerous subjective complaints of the patients, on the one hand, and the scanty data from objective studies, on the other (Joiner & Cornman, 1986;Montvila & Sargautite, 1983); indications of widespread anxiety disorders accompanying MVP and the unpleasant inclusion of the formation of "functional MVP" within panic disorder (some authors assert that panic attacks not only may be "triggered" by MVP but may lead to its development: Coplan, Papp, King, & Gorman, 1992;Gorman et al, 1988); cases of a genuine reduction in the intensity of clinical symptoms after psychotherapy and antidepressant or anxiolytic treatment (Gonzalez et al, 2002;Pariser, Reynolds, Falko, Jones, & Mencer, 1981;Scordo, 2007;Stavrakaki, Williams, Boisjoli, Vlad, & Chassé, 1991); there is even some evidence that such treatment may be symptomatolytic-that is, it may result in the complete disappearance of echocardiographic MVP indicators in patients suffering from panic disorders (Coplan et al, 1992).…”