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Has Psychiatric Treatment Any Role in the Management of Vasovagal Syncope?

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Cardiac Arrhythmias 2005
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Conclusions

Patients with recurrent vasovagal syncope frequently display mild to moderate psychiatric disorders, and the presence of psychiatric illness seem to predict the risk of recurrence. Thus, in our opinion, psychiatric evaluation should be included in the clinical management of patients with severe vasovagal syncope, because it may be valuable in identifying which subjects are at high risk of recurrence and really need long-term treatment. Psychiatric and psychological interventions seem to represent a promising treatment, at least in patients with refractory vasovagal syncope and in those with blood/injury phobia. However, before becoming a first-line therapy for most vasovagal fainters, the positive effects of psychiatric treatment need to be verified in larger, randomised and placebo-controlled trials.

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References

  1. Brignole M, Alboni P, Benditt DG et al (2004) Guidelines on management (diagnosis and treatment) of syncope — update 2004. Europace 6:467–537

    Article  PubMed  Google Scholar 

  2. Schmidt RT (1975) Personality and fainting. J Psychosom Res 19:21–25

    Article  PubMed  CAS  Google Scholar 

  3. Sledge WH (1978) Antecedent psychological factors in the onset of vasovagal syncope. Psychosom Med 40:568–579

    PubMed  CAS  Google Scholar 

  4. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th ed (DSM-IV). American Psychiatric Association, Washington DC, p 20

    Google Scholar 

  5. Sheldon R, Rose S, Flanagan P et al (1996) Risk factors for syncope recurrence after a positive tilt-table test in patients with syncope. Circulation 93:973–981

    PubMed  CAS  Google Scholar 

  6. Di Girolamo E, Di Iorio C, Sabatini P et al (1999) Effects of paroxetine hydrochloride, a selective serotonin re-uptake inhibitor, on refractory vasovagal syncope: a randomized, double-blind, placebo-controlled study. J Am Coll Cardiol 33:1227–1230

    Article  PubMed  Google Scholar 

  7. Kapoor WN, Fortunato M, Hanusa BH et al (1995) Psychiatric illnesses in patients with syncope. Am J Med 99:505–512

    Article  PubMed  CAS  Google Scholar 

  8. Linzer M, Felder A, Hackel A et al (1990) Psychiatric syncope: a new look at an old disease. Psychosomatics 31:181–188

    PubMed  CAS  Google Scholar 

  9. Koenig D, Linzer M, Pontinen M et al (1992) Syncope in young adults: evidence for combined medical and psychiatric approach. J Intern Med 232:169–176

    Article  PubMed  CAS  Google Scholar 

  10. Kouakam C, Lacroix D, Baux P et al (1996) Anxiety neurosis and unexplained syncope of presumed vaso-vagal origin. Arch Mal Coeur 89:1247–1254

    PubMed  CAS  Google Scholar 

  11. Cohen TJ, Thayapran N, Ibrahim B et al (2000) An association between anxiety and neurocardiogenic syncope during head-up tilt table testing. Pacing Clin Electrophysiol 23:837–841

    Article  PubMed  CAS  Google Scholar 

  12. Ventura R, Maas R, Ruppel R et al (2001) Psychiatric conditions in patients with recurrent unexplained syncope. Europace 3:311–316

    Article  PubMed  CAS  Google Scholar 

  13. Kouakam C, Lacroix D, Klug D et al (2002) Prevalence and prognostic significance of psychiatric disorders in patients evaluated for recurrent unexplained syncope. Am J Cardiol 89:530–535

    Article  PubMed  Google Scholar 

  14. Linzer M, Pontinen M, Gold DT et al (1991) Impairment of physical and psychosocial function in recurrent syncope. J Clin Epidemiol 44:1037–1043

    Article  PubMed  CAS  Google Scholar 

  15. Linzer M, Gold DT, Pontinen M et al (1994) Recurrent syncope as a chronic disease: preliminary validation of a disease-specific measure of functional impairment. J Gen Intern Med 9:181–185

    PubMed  CAS  Google Scholar 

  16. Rose MS, Koshman ML, Spreng S et al (2000) The relationship between health-related quality of life and frequency of spells in patients with syncope. J Clin Epidemiol 53:1209–1216

    Article  PubMed  CAS  Google Scholar 

  17. Giada F, Silvestri I, Rossillo A et al (2005) Psychiatric profile, quality of life and risk of syncopal recurrence in patients with tilt-induced vasovagal syncope. Europace (in press in press)

    Google Scholar 

  18. Butcher JN, Dahlstrom GW, Graham JR (1989) MMPI-2 manual for administration and scoring. University of Minnesota Press, Minneapolis, p 81

    Google Scholar 

  19. Pancheri P, Sirigatti S (1995) MMPI-2 Minnesota Multiphase Personality Inventory-2 manual. Italian adaptation. OS (Organizzazioni Speciali), Florence, Italy, p 34

    Google Scholar 

  20. Ware JE, Sherbourne CD (1992) The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Med Care 30:473–483

    PubMed  Google Scholar 

  21. Mc-Horney CA, Ware JE, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263

    Article  CAS  Google Scholar 

  22. McGrady AV, Kern-Buell C, Bush E et al (2003) Biofeedback-assisted relaxation therapy in neurocardiogenic syncope: a pilot study. Appl Psychophysiol Biofeedback 28:183–192

    Article  PubMed  Google Scholar 

  23. Newton JL, Kenny RA, Baker CR (2003) Cognitive behavioural therapy as potential treatment for vasovagal/neurocardiogenic syncope — a pilot study. Europace 5:299–301

    Article  PubMed  CAS  Google Scholar 

  24. Kadri NN, Hee TT, Rovang KS et al (1999) Efficacy and safety of clonazepam in refractory neurally mediated syncope. Pacing Clin Electrophysiol 22:307–314

    Article  PubMed  CAS  Google Scholar 

  25. Ost LG, Hellstrom K, Kaver A (1992) One versus five sessions of exposure in the treatment of injection phobia. Behav Res Ther 23:263–282

    Article  Google Scholar 

  26. Van Dijk N, Velzeboer SCJM, Destree-Vonk A et al (2001) Psychological treatment of malignant vasovagal syncope due to blood phobia. Pacing Clin Electrophysiol 24:122–124

    Article  PubMed  Google Scholar 

  27. Hellstrom K, Fellenius J, Ost LG (1996) One versus five sessions of applied tension in the treatment of blood phobia. Behav Res Ther 34:101–112

    Article  PubMed  CAS  Google Scholar 

  28. Marks I (1988) Blood-injury phobia: a review. Am J Psychiatry 145:1207–1213

    PubMed  CAS  Google Scholar 

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Giada, F., Silvestri, I., Rossillo, A., Madalosso, M., Nicotera, P.G., Raviele, A. (2006). Has Psychiatric Treatment Any Role in the Management of Vasovagal Syncope?. In: Raviele, A. (eds) Cardiac Arrhythmias 2005. Springer, Milano. https://doi.org/10.1007/88-470-0371-7_86

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  • DOI: https://doi.org/10.1007/88-470-0371-7_86

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0370-5

  • Online ISBN: 978-88-470-0371-2

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