Psychiatric profile, quality of life and risk of syncopal recurrence in patients with tilt-induced vasovagal syncope

The aim of this study was to investigate the prevalence of psychiatric disorders and quality of life (QoL) in patients with tilt-induced vasovagal syncope and no other comorbidities, and their relationship with the syncopal burden and the risk of recurrence.

We studied 61 patients with recurrent syncope and positive tilt testing. Controls consisted of 61 sex- and age-matched healthy subjects. Psychiatric diagnoses were formulated on the basis of a structured interview and the Minnesota Multiphase Personality Inventory-2 questionnaire. QoL was assessed by means of the Short-Form Health Survey questionnaire. Patients were followed up for at least 1 year.

The presence of psychiatric disorders was higher among patients than controls (71% vs. 23%, P <0.001), with a prevalence of anxiety (28% vs. 5%), mood (18% vs. 3%), and somatization disorders (29% vs. 3%). The scores of all the QoL scales were statistically lower in patients than controls. An inverse correlation was found between QoL scale scores and syncopal burden. The presence of psychiatric disorders was predictive of syncopal recurrence during follow-up.

Psychiatric disorders are common in patients with tilt-induced vasovagal syncope, and seem to predict the risk of recurrence. QoL is impaired in these patients, and is inversely correlated with the syncopal burden.