The Fainting Assessment Inventory: A 10-Item Instrument Developed to Screen for Psychogenic Nonsyncopal Collapse...

Area of Science:

• Neurology
• Psychiatry
• Clinical Diagnostics

Background:

• Conversion disorder presenting as syncope is common but often misdiagnosed.
• Differentiating psychogenic nonsyncopal collapse (PNSC) from neurally mediated syncope is clinically challenging in young patients.
• Accurate diagnosis is crucial for appropriate patient management and treatment.

Purpose of the Study:

• To develop and validate a brief, clinician-administered screening tool to distinguish PNSC from syncope in adolescents and young adults.
• To create a reliable instrument for identifying psychogenic causes of fainting.

Main Methods:

• Development of a 92-item inventory based on patient-reported features of PNSC and syncope.
• Iterative revision and validation of the inventory through multiple patient cohorts.
• Final validation using a 10-item Fainting Assessment Inventory (FAI-10) in distinct patient groups.

Main Results:

• The Fainting Assessment Inventory (FAI-10) demonstrated significant differences in scores between patients with PNSC and syncope (median scores -6 vs. 7; p < 0.001).
• High diagnostic accuracy was achieved: sensitivity (0.95), specificity (0.875), positive predictive value (0.889), and negative predictive value (0.93).
• The area under the receiver operating characteristic curve was 0.973, indicating excellent discriminative ability.

Conclusions:

• The FAI-10 is a validated, brief screening tool effective in differentiating PNSC from syncope in young patients.
• This inventory enhances clinicians' ability to diagnose various forms of transient loss of consciousness.
• The FAI-10 can improve diagnostic accuracy and guide appropriate therapeutic interventions for patients presenting with fainting episodes.