Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese 2017 02 14() pii S1109-9666(16)30337-2
Vasovagal syncope (VVS) is a clinical syndrome characterized by transient loss of consciousness and postural tone that is due to a temporary and spontaneously self-terminating global cerebral hypoperfusion. It is known that personality modulates the individual’s sensitivity to stressors, and emotional arousal and psychologic uncertainty are conditions contributing to vasodepressor syncope. Therefore it is postulated that personality characteristics of VVS patients could have 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 confirmed by nitrate-induced tilt testing.
From the 450 consecutive patients referred to our Syncope Unit for transient loss of consciousness, we enrolled 162 patients who had positive results at the head up tilt test for vasovagal syncope (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 fill up the Cloninger’s Temperament and Character Inventory-Revised (TCI-R) questionnaire for psychological assessment.
Compared to healthy subjects, both male and female patients with VVS were found to have higher scores of persistence temperament trait and self-transcendence character trait. Moreover, male VVS patients showed lower scores in "novelty seeking" while female VVS patients scored significantly higher in "reward dependence".
Our data shows that VVS patients significantly differ from matched healthy controls in some temperament and character personality dimensions. Cardiologists should consider referral for a psychological assessment when dealing with patients with refractory VVS.