title: Association between psychological complaints and recurrence of vasovagal syncope.
abstract: OBJECTIVE
  Vasovagal syncope (VVS), the most common cause of transient loss of consciousness (T-LOC), is often accompanied by higher levels of psychological distress.                         We investigated to what extent psychological complaints interact with the effects of non-pharmacological treatment in patients with frequently recurring VVS.
  
  
  METHODS
  Patients with ≥3 episodes of VVS in the 2 years prior to the start of the study openly received non-pharmacological treatment. Before treatment initiation, we determined the level of general psychological complaints by the Symptom Checklist 90-R (SCL-90-R) questionnaire. We regularly evaluated syncopal recurrence during follow-up. We compared the SCL-90-R scores of VVS patients in our study with the corresponding scores of healthy Dutch subjects (reference population). We examined whether patients with more recurrences during follow-up had higher SCL-90-R scores at baseline and whether this association changed when adjusting for other factors associated with recurrence using logistic regression.
  
  
  RESULTS
  Total SCL-90-R scores were higher in our cohort of patients with frequent episodes of VVS than in the reference population (142 vs. 118; p < 0.001). During the first 6 months of treatment, 42% of patients experienced syncopal recurrence(s). The SCL-90-R scores of these patients were significantly higher compared with patients without syncopal recurrence in this period (160 vs. 130; p = 0.01). After adjusting for other predictors of recurrence, especially the number of episodes before inclusion, the association between SCL-90-R scores and recurrence remained intact.
  
  
  CONCLUSIONS
  Levels of general psychological complaints are higher in patients with syncopal recurrence during non-pharmacological treatment of VVS, even after adjusting for previous syncopal episodes.
authors.affiliation: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Jacobus J C M
authors.initials: JJ
authors.lastname: Romme
authors.forename: Nynke
authors.initials: N
authors.lastname: van Dijk
authors.forename: Ingeborg K
authors.initials: IK
authors.lastname: Go-Schön
authors.forename: Gerty
authors.initials: G
authors.lastname: Casteelen
authors.forename: Wouter
authors.initials: W
authors.lastname: Wieling
authors.forename: Johannes B
authors.initials: JB
authors.lastname: Reitsma
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D012008:Recurrence; D011795:Surveys and Questionnaires; D019462:Syncope, Vasovagal / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*