© 2001 by European Society of Cardiology
SYNCOPE
Psychiatric conditions in patients with recurrent unexplained syncope
Department of Cardiology, University Hospital Eppendorf Hamburg, Germany; 1Department of Psychosomatic Medicine, University Hospital Eppendorf Hamburg, Germany
Abstract
AIMS: The relationship between syncope and psychiatric disorders is little investigated. This study evaluated the prevalence of psychiatric diseases and prognostic outcome in patients with recurrent unexplained syncope.
METHODS AND RESULTS: After an inconclusive standard diagnostic work-up for syncope, including head-up tilt testing, a psychiatric evaluation was offered to 50 consecutive patients with recurrent syncope. The evaluation was accepted by 26 patients (77% females, 36±16 years) and refused by 24 (63% females, 50±19 years). A psychiatric disorder was diagnosed in 21 (81%) patients: 12 had depression, four panic attacks, two general anxiety, and three a somatization disorder. Only five patients showed normal psychosocial function. Of the patients with psychiatric disorders four accepted psychiatric care, such as psychotherapy and/or pharmacotherapy; 17 patients refused treatment. During 6 months of follow-up no patient under psychiatric care had syncope, while all patients without psycho- or pharmacotherapy had recurrent syncopal events. In these patients the median of syncopal episodes was three in a 6 months interval before and after clinical assessment. Patients who refused both psychiatric evaluation and therapy continued to experience syncope as before.
CONCLUSIONS: In patients with recurrent unexplained syncope psychiatric alteration is common. However, patients seldom accepted a psychiatric evaluation and treatment.
Key Words: Recurrent unexplained syncope, psychiatric diseases
Correspondence: Rodolfo Ventura, MD, Department of Cardiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. E-mail: ventura{at}uke.uni-hamburg.de
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