title: Temperament and character personality dimensions in nitrate-tilt-induced vasovagal syncope patients.
abstract: OBJECTIVE
  Vasovagal syncope (VVS) is a clinical syndrome that is characterized by a transient loss of consciousness and postural tone that are due to a temporary, spontaneously self-terminating global cerebral hypoperfusion. It is known that personality modulates the individual's sensitivity to stressors and that emotional arousal and psychologic uncertainty are conditions that contribute to vasodepressor syncope. Therefore, it is postulated that the personality characteristics of VVS patients could play a role in the pathophysiology of VVS. The aim of our study was to evaluate the temperament and character personality dimensions in patients with VVS as confirmed by nitrate-induced tilt testing.
  
  
  METHODS
  From the 450 consecutive patients referred to our Syncope Unit for transient loss of consciousness, we enrolled 162 patients who had positive results from the head up tilt test for VVS and 162 healthy subjects matched for age and sex. All patients underwent a structured clinical interview with a psychologist to exclude the presence of current psychiatric comorbidities and were asked to complete the Cloninger's Temperament and Character Inventory-Revised (TCI-R) questionnaire for psychological assessment.
  
  
  RESULTS
  Compared to healthy subjects, both male and female patients with VVS were found to have higher scores of the persistence temperament and self-transcendence character traits. Moreover, male VVS patients had lower scores in "novelty seeking", while female VVS patients scored significantly higher in "reward dependence".
  
  
  CONCLUSIONS
  Our data show that VVS patients significantly differ from matched healthy controls in some temperament and character personality dimensions. Cardiologists should consider referral for psychological assessment when treating patients with refractory VVS.
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples - Monaldi Hospital, Naples, Italy. Electronic address: v.p.russo@libero.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Russo
authors.affiliation: McGill University Health Centre (MUHC), Montreal, Quebec, Canada.
authors.forename: Ahmed
authors.initials: A
authors.lastname: AlTurki
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples - Monaldi Hospital, Naples, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Rago
authors.affiliation: McGill University Health Centre (MUHC), Montreal, Quebec, Canada; Cardiac Electrophysiology Laboratory, Luigi Sacco Hospital, Milano, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Proietti
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples - Monaldi Hospital, Naples, Italy.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Chaussé
authors.affiliation: Department of Psychiatry, Second University of Naples, Italy.
authors.forename: Alessio Maria
authors.initials: AM
authors.lastname: Monteleone
authors.affiliation: Department of Psychiatry, Second University of Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Scognamiglio
authors.affiliation: Department of Psychiatry, Second University of Naples, Italy; Neurosciences Section, Department of Medicine and Surgery, University of Salerno, Italy.
authors.forename: Palmiero
authors.initials: P
authors.lastname: Monteleone
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples - Monaldi Hospital, Naples, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Nigro
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D002605:Character; D018618:Echocardiography, Doppler, Color; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality / Q000502:physiology*; D015995:Prevalence; D011594:Psychometrics / Q000379:methods; D013315:Stress, Psychological / Q000150:complications; D019462:Syncope, Vasovagal / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D013694:Temperament / Q000502:physiology; D018667:Tilt-Table Test / Q000379:methods*
keywords: Personality; Temperament; Vasovagal syncope