Source:Pediatric Neurology
Author(s): Geoffrey L. Heyer
BackgroundLittle is known about somatic and psychiatric symptoms and perceived peer relationships of patients with psychogenic non-syncopal collapse (PNSC).ObjectiveTo compare several somatic and psychiatric symptoms and other elements potentially related to functional neurological symptom disorders between youth diagnosed with PNSC and those diagnosed with neurally-mediated syncope.MethodsPrior to tilt-table testing, patients completed a structured interview and questionnaires addressing current symptoms, previous psychiatric diagnoses, previous referrals and diagnostic testing, previously prescribed medications, and patient self-ratings of current anxiety and depression symptoms and perceived peer relationships.ResultsCompared to patients with syncope (n=60), patients with PNSC (n=60) had higher ratings for lightheadedness and vertigo, more abdominal pain, more chronic headaches, more fatigue, more sleep disturbances, more prescriptions for antidepressant medicines, more EEGs performed, more referrals to psychiatry, and more psychiatric diagnoses including anxiety, depression, PTSD, previous non-fainting conversion disorders, and eating disorders (all p<0.05). Patients with PNSC rated their anxiety (10.5 ± 7.7 versus 5.9 ± 5.8, p<0.001) and depression (8.7 ± 8.3 versus 3.1 ± 5, p<0.001) symptoms higher and their peer relationships (37 ± 12.3 versus 47.6 ± 7.9, p<0.001) lower than patients with syncope. Peer relationships remained significantly lower (p=0.001) when analyzed in a regression model that included anxiety and depression.ConclusionsPatients with PNSC have more symptom complaints and perceptions of poorer peer social interactions than patients with syncope. These results broaden our understanding of the biopsychosocial profile that increases an individual's vulnerability to PNSC specifically and to functional neurological symptom disorders in general.
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