Psychiatric traits in patients with vasovagal and unexplained syncope

Abstract

PurposeSyncope is a common condition affecting almost one-third of the general population. The present study measures the prevalence of psychiatric traits in patients presenting with syncope (unexplained and vasovagal) and whether recurrent attacks have an impact on psychiatric profiles.Patients and methodsThis is a case–control study in a tertiary hospital enrolling all patients aged ≥12 years with single or recurrent syncopal attacks. A self-reporting psychometric questionnaire (The Symptoms Checklist-90-Revised) was used to screen for depression, anxiety, somatization disorder, and phobia. Crude comparisons of average scores were done. Further, multiple logistic regression analyses were carried out to measure the impact of syncope on each psychiatric domain. The control group were matched for age, gender, and chronic illnesses with a ratio of 1:3.ResultsThere were 43 cases and 129 control subjects, with predominance of females (67.4%) and an average age of 33.8 years (standard deviation = 16). There were no significant differences in average scores of depression (13 vs 14.53, P = 0.31), anxiety (11.3 vs 10.4, P = 0.51), or phobia (5.4 vs 5.2, P = 0.88). However, the syncope group had a higher average score for somatization disorder (18.53 vs 13.66, P = 0.002). Binary logistic regression model showed that the association between syncope and somatization disorder was independent of competing confounders (odds ratio = 3.75, 95% confidence interval: 1.72, 8.15, P = 0.001). A sub-analysis of the case group showed that patients with multiple syncopal attacks (six or more) had higher average scores of depression, anxiety, phobia, and somatization disorder compared to those who had less than six attacks.ConclusionSyncope was independently associated with somatization disorder traits. Further, recurrent syncope resulted in greater deterioration of patients’ psychiatric profiles. Thus, taking into account the psychiatric status in the management of such patients is crucial.

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

“…Increased event frequency, or syncopal recurrence during follow up, are associated with reduced quality of life in both physical and mental health domains in patients with VVS. Syncopal recurrence is also more common in patients with VVS who have concurrent psychiatric disorders ( 29 ), and conversely, patients who report more frequent syncopal events, are more likely to have a concurrent psychiatric disorder or psychiatric symptoms ( 62 , 63 ). Whether psychological distress predisposes to syncope in susceptible individuals, or whether syncope contributes to psychological distress, is not clear.…”

The Psychopathology, Depression, and Anxiety Levels of Children and Adolescents With Vasovagal Syncope

“…However, a statistically significant difference for somatization disorder was found between the groups. In the same study, a subanalysis of the case group showed that patients with six or more syncopal episodes had higher rates of depression, anxiety, and somatization disorder compared with those with lesser syncopal attacks (Alhuzaimi et al, 2018). In another study, Giada et al (2005) reported that they found psychopathology in 71% of patients with vasovagal syncope, with a prevalence of somatization disorders (29%), anxiety disorders (28%), and mood disorders (18%).…”

“…Less commonly encountered cardiacoriginating syncope indicates a serious health concern (Massin et al, 2007;Yeh, 2015). Alhuzaimi et al (2018) compared patients with syncope in the adult age group with a control group and found no difference between the groups in terms of depression, anxiety, and phobia. However, a statistically significant difference for somatization disorder was found between the groups.…”

Utilidad de la midodrina para controlar el síncope vasovagal: ¿la recomienda la evidencia?

“…The relevance of clinically studying, investigating, preventing, and controlling this condition lies in its adverse impact on the affected individual. Atici et al (9), Ng et al (10), and Alhuzaimi et al (11) evaluated the relationship between clinical manifestations, psychological conditions, and quality of life of patients with VVS. They showed that the total number of syncopal episodes is positively and significantly associated with higher levels of distress, anxiety, depression, other somatization types, and low quality of life, especially in recurrent syncope (Figure 1) (9)(10)(11).…”