Syncope: recurrent syncope was associated with raised levels of psychosocial and physical distress.

Clinical bottom line (level 4)

  1. Patients with recurrent syncope who attended syncope clinics had high levels of sickness-related dysfunction and psychiatric distress.
Linzer et al: Clinical Epidemiology 1991; 44: 1037-1043
Expires October 2004

The study

Case series with ?objective ?blinded outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: syncope clinic, university hospital, USA

62 patients (aged mean 49 years, 71% female) at least two episodes of syncope or near syncope in the prior six months

Excluded if
  • aged <17
  • clinical evidence of dementia


    • Patients completed questionnaires of health status.
    • Sickness-impact-profile (reporting sickness-related dysfunction)
    • Symptom-checklist-90-R scores (reporting psychiatric distress)



    Outcomes studied:

    The evidence


    • syncope population:
      • SIP score: 16.8
      • Psychosocial sub-scale: 19.9
      • Physical sub-scale: 11.1
    • 'Population normal':
      • SIP score: 3.6
    • SCL-90 (measure of psychological distress):
      • syncope: 0.98
      • 'population normal': 0.31
      • 'psychiatric inpatients': 1.30
    • 48% of patients had a final diagnosis of unknown cause.

    Comments

    1. These SIP scores are similar to patients with rheumatoid arthritis or on chronic peritoneal dialysis for end-stage renal disease.
    2. No comparison group within the study weakens the design. The comparisons cited apply to groups with very different clinical problems.

    Citation

    1. Linzer M, et al: Impairment of physical and psychosocial function in recurrent syncope.. Clinical Epidemiology 1991; 44: 1037-1043
    Contributor: Bob Phillips and Chris Ball, October 2000
    Reviewer:

    Clinical Question.
    Patient recurrent syncope
    Intervention or Exposure attend syncope clinic
    Outcome psychiatric distress