Syncope is a common disorder accounting for up to 3% of emergency department visits and 6% of hospital admissions.<sup>4 Day S.C., Cook E.F., Funkenstein H. , e al. Evaluation and outcome of emergency room patients with transient loss of consciousness Am J Med 1982 ;  73 : 15-23  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Although studies have reported a high prevalence of psychiatric illness in patients with syncope,<sup>10 Kapoor W.N., Fortunato M., Hanusa B.H. , e al. Psychiatric illness in patients with syncope Am J Med 1995 ;  99 : 505-512  [inter-ref]

Cliccare qui per andare alla sezione Riferimenti, 11 Koenig D., Linzer M., Pontinen M. , e al. Syncope in young adults: Evidence for a combined medical and psychiatric approach J Intern Med 1992 ;  232 : 169-176  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> fewer than 5% of patients have been assigned psychiatric diagnoses in cohort studies from the 1980s.<sup>4 Day S.C., Cook E.F., Funkenstein H. , e al. Evaluation and outcome of emergency room patients with transient loss of consciousness Am J Med 1982 ;  73 : 15-23  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 5 Eagle K.A., Black H.R., Cook E.F. , e al. Evaluation of prognostic classifications for patients with syncope Am J Med 1985 ;  79 : 455-460  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 9 Kapoor W.N. Evaluation and outcome of patients with syncope Medicine 1990 ;  69 : 160-175

Cliccare qui per andare alla sezione Riferimenti, 20 Martin G.J., Adams S.L., Martin H.G. , e al. Prospective evaluation of syncope Ann Emerg Med 1984 ;  13 : 499-504  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 27 Silverstein M.D., Singer D.E., Mulley A.G. Patient with syncope admitted to medical intensive care units JAMA 1982 ;  248 : 1185-1189

Cliccare qui per andare alla sezione Riferimenti</sup> This may be due to lack of standardized assessment for psychiatric illness in the earlier studies. Physicians did not recognize psychiatric illness in half of the patients in one study.<sup>10 Kapoor W.N., Fortunato M., Hanusa B.H. , e al. Psychiatric illness in patients with syncope Am J Med 1995 ;  99 : 505-512  [inter-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Thus, there is a need to understand better the association of psychiatric illnesses and syncope. This article reviews the association of psychiatric illness and syncope and provides recommendations for incorporating psychiatric assessment in the evaluation of syncope.

In an evaluation of 414 patients with syncope using Diagnostic Interview Schedule (DIS), a structured interview administered to formulate DSM-III-R diagnosis, the authors found that the prevalence of psychiatric illnesses was highest in the syncope of unknown origin group and lowest in the cardiac syncope group (24.5% and 9.7%, P < .04). The most frequent diagnoses were major depressive disorder (MDD) in 9.9%, general anxiety disorder (GAD) in 7.3%, and alcohol dependence in 6.5% (Table 1).<sup>10 Kapoor W.N., Fortunato M., Hanusa B.H. , e al. Psychiatric illness in patients with syncope Am J Med 1995 ;  99 : 505-512  [inter-ref]

Cliccare qui per andare alla sezione Riferimenti</sup>

Linzer and colleagues<sup>14 Linzer M., Felder A., Hackel A. , e al. Psychiatric syncope: A new look at an old disease Psychosomatics 1990 ;  31 : 181-188  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> had 72 patients with syncope evaluated by psychiatrists and found 17 (24%) in whom the cause of the syncope was attributed to a psychiatric disorder. Those patients were reported to have the diagnosis of panic disorder (PD) in 12.5%, MDD in 8.3%, MDD plus panic attacks in 2.8%, and conversion disorder in 2%.

Patients with syncope and psychiatric disorders were younger, had more prodromal symptoms, had a higher number of syncopal episodes in the last 6 to 12 months before evaluation,<sup>10 Kapoor W.N., Fortunato M., Hanusa B.H. , e al. Psychiatric illness in patients with syncope Am J Med 1995 ;  99 : 505-512  [inter-ref]

Cliccare qui per andare alla sezione Riferimenti, 14 Linzer M., Felder A., Hackel A. , e al. Psychiatric syncope: A new look at an old disease Psychosomatics 1990 ;  31 : 181-188  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 17 Linzer M., Varia I., Pontinen M. , e al. Medically unexplained syncope: Relationship to psychiatric illness Am J Med 1992 ;  92 : 18S-25S

Cliccare qui per andare alla sezione Riferimenti</sup> and had a larger number of other complaints.<sup>10 Kapoor W.N., Fortunato M., Hanusa B.H. , e al. Psychiatric illness in patients with syncope Am J Med 1995 ;  99 : 505-512  [inter-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> In the authors' study, when psychiatric disorders were subdivided into alcohol/substance abuse or psychiatric disorders, multivariate predictors for the former were male gender and age less than 65 years and for the latter having four or more episodes of syncope in the past year and prodromal symptoms before syncope.<sup>10 Kapoor W.N., Fortunato M., Hanusa B.H. , e al. Psychiatric illness in patients with syncope Am J Med 1995 ;  99 : 505-512  [inter-ref]

Cliccare qui per andare alla sezione Riferimenti</sup>