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Comparative Study
. 2019 Feb;42(2):180-188.
doi: 10.1111/pace.13559. Epub 2018 Dec 10.

Reduced quality of life and greater psychological distress in vasovagal syncope patients compared to healthy individuals

Jessica Ng  1 , Robert S Sheldon  1 , Debbie Ritchie  1 , Vidya Raj  1   2 , Satish R Raj  1   3
Affiliations
Comparative Study

Reduced quality of life and greater psychological distress in vasovagal syncope patients compared to healthy individuals

Jessica Ng et al. Pacing Clin Electrophysiol. 2019 Feb.

Abstract

Background: Vasovagal syncope (VVS) patients have a reduced health-related quality of life (HRQoL). There are limited data comparing HRQoL and psychological profile in VVS patients and healthy individuals. We tested the hypothesis that VVS patients have greater impairment in both HRQoL and psychological profile compared to healthy nonfainting individuals, and that both outcome measures are negatively correlated for VVS patients.

Methods: The RAND 36-Item Health Survey (RAND36), global health visual analogue scale (VAS), Hospital Anxiety and Depression Scale, Anxiety Sensitivity Index, and Positive and Negative Affect Schedule - Expanded Form were completed by healthy individuals and at baseline by VVS patients enrolled in the Second Prevention of Syncope Trial, a randomized, placebo-controlled trial of fludrocortisone for VVS.

Results: Data were available on 76 VVS patients (34 ± 14 years; 68% F) and 85 healthy participants (35 ± 11 years; 80% F). Compared to healthy participants, VVS patients reported poorer HRQoL on all scales of the RAND36 and the VAS. VVS patients had significantly greater anxiety, depression, and anxiety sensitivity (each P < 0.001). VVS patients had more negative affect (P < 0.001) and less positive affect (P = 0.003) compared to healthy participants. Anxiety, depression, and anxiety sensitivity were negatively correlated with HRQoL for VVS patients, but not for healthy participants.

Conclusion: In this first direct comparison, VVS patients have a significantly reduced HRQoL and more anxiety and depression compared to healthy nonfainting individuals. For VVS patients, there is a relationship between psychological distress and HRQoL, suggesting a potential benefit from more comprehensive assessment and treatment.

Keywords: anxiety; depression; quality of life; vasovagal syncope.

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Conflict of interest statement

DISCLOSURES

SRR is a consultant for Lundbeck NA Ltd., GE Healthcare, Abbott Laboratories, and Boston Scientific Corporation. Other authors have no conflicts to declare.

Figures

Figure 1.
Figure 1.. HRQoL Scores of VVS Patients and Healthy Individuals
Higher scores in each scale indicate greater levels of functioning and a more favourable health state. Panel A: Compared to healthy individuals, VVS patients reported poorer scores in all 8 of the health dimensions of the RAND36. Panel B: VVS patients also scored lower in the global assessments of HRQoL, measured by the RAND36 physical and mental health composite scores and global health visual analogue scale. PF – physical functioning; GH – general health; RL−P – role limitations due to physical health; P – pain; EWB – emotional well−being; SF – social functioning; EF – energy/fatigue; RL−E – role limitations to due emotional health; PHC – physical health composite; MHC – mental health composite; VAS – visual analogue scale.
Figure 1.
Figure 1.. HRQoL Scores of VVS Patients and Healthy Individuals
Higher scores in each scale indicate greater levels of functioning and a more favourable health state. Panel A: Compared to healthy individuals, VVS patients reported poorer scores in all 8 of the health dimensions of the RAND36. Panel B: VVS patients also scored lower in the global assessments of HRQoL, measured by the RAND36 physical and mental health composite scores and global health visual analogue scale. PF – physical functioning; GH – general health; RL−P – role limitations due to physical health; P – pain; EWB – emotional well−being; SF – social functioning; EF – energy/fatigue; RL−E – role limitations to due emotional health; PHC – physical health composite; MHC – mental health composite; VAS – visual analogue scale.
Figure 2.
Figure 2.. Psychological Profile Scores of VVS Patients and Healthy Individuals
Higher scores indicate greater experiences of anxiety, depression, and anxiety sensitivity. Panel A: Compared to healthy individuals, VVS patients reported greater anxiety and depression using the HADS (left axis) and greater anxiety sensitivity using the ASI (right axis). Panel B: In the PANAS−X, VVS patients reported more negative affect and less positive affect compared to healthy individuals.
Figure 2.
Figure 2.. Psychological Profile Scores of VVS Patients and Healthy Individuals
Higher scores indicate greater experiences of anxiety, depression, and anxiety sensitivity. Panel A: Compared to healthy individuals, VVS patients reported greater anxiety and depression using the HADS (left axis) and greater anxiety sensitivity using the ASI (right axis). Panel B: In the PANAS−X, VVS patients reported more negative affect and less positive affect compared to healthy individuals.
Figure 3.
Figure 3.. Correlations between Psychological Distress and HRQoL in VVS Patients
Panel A: Anxiety, as measured by the HADS, is negatively correlated with the physical and mental health composite scores of the RAND36. Panel B: Depression, as measured by the HADS, is negatively correlated with the physical and mental health composite scores of the RAND36. Panel C: Increases in anxiety sensitivity (in the ASI) are associated with a decrease in both physical and mental health (in the RAND36). PH Composite – physical health composite; MH Composite – mental health composite.
Figure 3.
Figure 3.. Correlations between Psychological Distress and HRQoL in VVS Patients
Panel A: Anxiety, as measured by the HADS, is negatively correlated with the physical and mental health composite scores of the RAND36. Panel B: Depression, as measured by the HADS, is negatively correlated with the physical and mental health composite scores of the RAND36. Panel C: Increases in anxiety sensitivity (in the ASI) are associated with a decrease in both physical and mental health (in the RAND36). PH Composite – physical health composite; MH Composite – mental health composite.
Figure 3.
Figure 3.. Correlations between Psychological Distress and HRQoL in VVS Patients
Panel A: Anxiety, as measured by the HADS, is negatively correlated with the physical and mental health composite scores of the RAND36. Panel B: Depression, as measured by the HADS, is negatively correlated with the physical and mental health composite scores of the RAND36. Panel C: Increases in anxiety sensitivity (in the ASI) are associated with a decrease in both physical and mental health (in the RAND36). PH Composite – physical health composite; MH Composite – mental health composite.
See this image and copyright information in PMC

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