Depressive Symptoms and Neurocardiogenic Syncope in Children: A 2-Year Prospective Study

Departments of Psychiatry.
PEDIATRICS (Impact Factor: 5.3). 10/2012; 130(5). DOI: 10.1542/peds.2012-1379
Source: PubMed

ABSTRACT OBJECTIVE:To evaluate prospectively the relationship between neurocardiogenic syncope (NCS) and depressive symptoms in pediatric patients.METHODS:Forty-five patients (aged 12.3 ± 2.9 years) with NCS (diagnosed as ≥1 syncopal episodes with typical symptoms, reproduced by tilt-table testing, in the absence of structural or primary electrical heart disease) were compared with 45 age- and gender-matched control subjects. Assessment was performed at baseline and 2 years thereafter. Depressive symptoms and self-perception profile of participants were evaluated, along with their parents' psychological distress, defensive profile and hostility. Family cohesion and adaptability, as well as the opinion of parents and teachers on children's strengths and difficulties, were also examined.RESULTS:At baseline, patients showed more (P = .008) depressive symptoms than controls, correlating with the number of syncopal episodes, impaired relationship with parents and poor family cohesion. A conservative management strategy of NCS was adopted and psychological counseling was offered, focusing on patients with clinically significant depressive symptoms and their families. During follow-up, depressive symptoms decreased in patients (P < .001), but remained stable in controls. Child-parent relationship, family cohesion and family adaptability improved at follow-up in patients. No recurrent syncope was noted during follow-up and this along with improvement in child-parent relationship were associated with depressive symptoms improvement.CONCLUSIONS:Depressive symptomatology is common in pediatric patients with NCS. Our findings call for additional investigation in larger controlled clinical interventional studies that will enhance understanding of the possible pathophysiological association between depressive symptomatology and NCS in pediatric populations.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study is to determine the level of depressive symptoms among a sample of Greek children aged 8-12 years, as measured by the Greek Children's Depression Inventory (CDI), as well as to examine CDI's psychometric properties. A nationwide school-based sample of 650 children was initially recruited and depressive symptoms were assessed with the CDI among 538 children who provided all relevant information. Statistical evaluation included assessment of CDI internal reliability, test-retest reliability, determination of age, gender and socioeconomic status (SES) effects. Based on the distributions of CDI scores observed in this normative sample, a recommended cutoff score, identifying a high probability of serious levels of depressive symptoms that need to be further evaluated, was defined. Internal reliability and test-retest reliability were satisfactory and the expected associations with age and gender were observed. High SES was correlated with significantly less depression symptoms. The prevalence of depressive risk, when the cutoff point of 19 or 13 was taken as threshold, was much lower than those obtained from studies in other countries. The cutoff point of 15, corresponding to 90th percentile of the present sample, may be used as a screening threshold for further assessment. The present results are encouraging providing evidence about the psychometric properties of the CDI and implications for child mental health promotion planning in Greece. Further validation of the CDI against other measures and psychiatric diagnoses is needed.
    European Child & Adolescent Psychiatry 04/2009; 18(8):485-92. DOI:10.1007/s00787-009-0005-z · 3.55 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The authors examined associations among parental and child adjustment, child syncope, somatic, and school problems. Participants were children (N = 56) ages 7-18 years with syncope. Measures included syncope severity, parental distress, and children's internalizing symptoms. For children diagnosed negative for neurocardiogenic syncope (NCS), their fathers' and their own psychological symptoms were positively associated with the severity of syncope, whereas their mothers' functioning was negatively associated with the severity of syncope. Also, for the negative NCS group, fathers' psychological functioning was associated with children's nonsyncope somatic complaints but not with their school problems. For the positive NCS group, few significant father-child associations were found, but several significant positive associations were revealed between mothers' psychological symptoms and their children's syncope as well as somatic and school problems.
    Journal of Consulting and Clinical Psychology 09/2004; 72(4):597-604. DOI:10.1037/0022-006X.72.4.597 · 4.85 Impact Factor
  • Europace 04/2010; 12(4):466-7. DOI:10.1093/europace/euq004 · 3.05 Impact Factor