TY - JOUR
T1 - Syncope in young adults
T2 - evidence for a combined medical and psychiatric approach
AU - KOENIG, D.
AU - Linzer, Mark
AU - PONTINEN, M.
AU - DIVINE, G. W.
PY - 1992/8
Y1 - 1992/8
N2 - To determine the principal causes and effects of syncope in young adults, we prospectively evaluated 197 consecutive patients referred to a Syncope Specialty Clinic, comparing young (age 16–39 years, n = 71), middle‐aged (age 40–65 years, n = 70) and elderly (> age 65 years, n = 56) patients. Psychiatric aetiologies were significantly more common in young patients (39% vs. 20% in middle‐aged, and 3.6% in the elderly; P < 0.001), while cardiac aetiologies were rare in the young (2.8% vs. 12% in the middle‐aged, and 16% in the elderly; P < 0.04). These differences were still significant after controlling for gender. Because psychiatric causes are so common in young patients, we evaluated hyperventilation as a bedside test for syncope patients and found it to have a positive predictive value of 59% for psychiatric causes of syncope. Syncope interfered with daily activities in 62% of young patients, and resulted in anxiety or depression in 70% of the young (no difference when compared with other age groups). Thus syncope in young adults can be a disabling medical condition requiring a unique medical and psychological approach to diagnosis and treatment. 1992 Blackwell Publishing Ltd
AB - To determine the principal causes and effects of syncope in young adults, we prospectively evaluated 197 consecutive patients referred to a Syncope Specialty Clinic, comparing young (age 16–39 years, n = 71), middle‐aged (age 40–65 years, n = 70) and elderly (> age 65 years, n = 56) patients. Psychiatric aetiologies were significantly more common in young patients (39% vs. 20% in middle‐aged, and 3.6% in the elderly; P < 0.001), while cardiac aetiologies were rare in the young (2.8% vs. 12% in the middle‐aged, and 16% in the elderly; P < 0.04). These differences were still significant after controlling for gender. Because psychiatric causes are so common in young patients, we evaluated hyperventilation as a bedside test for syncope patients and found it to have a positive predictive value of 59% for psychiatric causes of syncope. Syncope interfered with daily activities in 62% of young patients, and resulted in anxiety or depression in 70% of the young (no difference when compared with other age groups). Thus syncope in young adults can be a disabling medical condition requiring a unique medical and psychological approach to diagnosis and treatment. 1992 Blackwell Publishing Ltd
KW - clinical epidemiology
KW - functional impairment
KW - syncope
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U2 - 10.1111/j.1365-2796.1992.tb00567.x
DO - 10.1111/j.1365-2796.1992.tb00567.x
M3 - Article
C2 - 1506814
AN - SCOPUS:0026643957
SN - 0954-6820
VL - 232
SP - 169
EP - 176
JO - Journal of Internal Medicine
JF - Journal of Internal Medicine
IS - 2
ER -