Dysfunctional Behaviors in Children and Adolescents with Neurocardiogenic Syncope

Objective: We evaluate a large sample of children and adolescent with suspected neurocardiogenic syncope (NCS) and we compared the results with a healthy sample, with the aim to reveal a possible correlation between syncopal events and dysfunctional behaviors. Methods: A total number of ninety two patients with NCS (median age 14.7 years) were evaluated with Head-Up Tilt Test (HUTT) and psychological assessment at the same time. The results of the ninety two patients who underwent HUTT and completed psychological tests were compared with a normative group. The risk of psychosocial dysfunctions was assessed by using the standardized Italian version of the Child Behavior Checklist in Youth Self Report (YSR). Results: Compared with normative group, patients with NCS reported worse scores to the internalizing and total problem scales and to the syndrome scales of anxiety problems, depressive withdrawal problems, somatic complaints, social problems and thought problems. Conclusions: Patients with NCS present major emotional and behavioral dysfunctions than healthy sample. Our findings call for additional investigations on the possible pathophysiological association between psychosocial problems and the reflex mechanism that produces syncope. Furthermore, future clinical studies are necessary to plan an interventional strategy and optimize the clinical management.