Fits, faints and funny turns. Could it be a mental disorder?
BACKGROUND
Patients who present to primary care with symptoms of fainting and dizziness, for which there is no adequate physical explanation, are frequently suffering from an undiagnosed psychiatric disorder.


OBJECTIVE
This article aims to improve the recognition of common mental disorders presenting as 'fits, faints and funny turns' (FFFTs) and to encourage general practitioners to view these disorders as a positive diagnosis in need of treatment.


CONCLUSIONS
Psychiatric disorders, particularly panic attacks and depression, are common in the setting of FFFTs and should be a positive diagnosis rather than a diagnosis of exclusion. A detailed description of the episode, with corroborating information from a witness if possible, and psychiatric rating scales can assist in this process. Identifying a physical cause for the episode does not exclude a psychiatric diagnosis and vice versa. Specific psychological and pharmacological therapies are effective for anxiety and depression.
Southview Clinic, St. George Private Hospital. hughm@bigpond.net.au
Hugh
H
Morgan
Grant
G
Blashki
D000328:Adult; D000465:Algorithms; D015984:Causality; D003663:Decision Trees; D003866:Depressive Disorder / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D004244:Dizziness / Q000209:etiology*; D005194:Family Practice / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000379:methods; D016584:Panic Disorder / Q000150:complications* / Q000175:diagnosis; D010808:Physical Examination / Q000379:methods; D011320:Primary Health Care / Q000379:methods; D011569:Psychiatric Status Rating Scales; D012640:Seizures / Q000209:etiology*; D013575:Syncope / Q000209:etiology*