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Psychiatric syncope: a new look at an old disease
1Department of Medicine, Duke University Medical Center, Durham, North Carolina.
Psychosomatics
|January 1, 1990
Summary
Psychiatric disorders are a common cause of unexplained syncope and presyncope, particularly in younger patients. Treatment targeting psychiatric conditions effectively resolves these symptoms in most cases.
Area of Science:
- Neurology
- Psychiatry
- Cardiology
Background:
- Unexplained syncope and presyncope are common clinical challenges.
- Psychiatric disorders are often overlooked as a cause of these symptoms.
Purpose of the Study:
- To investigate the prevalence and characteristics of psychiatric disorders in patients with unexplained syncope or presyncope.
- To evaluate the efficacy of psychiatric treatment for these symptoms.
Main Methods:
- A standardized evaluation was performed on 72 patients referred to the Duke Syncope Clinic.
- Patients were assessed for psychiatric diagnoses, including panic disorder and major depression.
Main Results:
- Psychiatric diagnoses explained symptoms in 24% of patients.
- Patients with psychiatric diagnoses were younger, experienced more disability, and had more frequent episodes.
- Treatment directed at psychiatric conditions led to symptom remission in 90% of compliant patients.
Conclusions:
- Psychiatric disorders are a significant, often unrecognized, cause of syncope and presyncope.
- Specific patient and prodrome characteristics may indicate a psychiatric etiology.
- Targeted psychiatric treatment offers a highly effective therapeutic option.