Correlates and predictors of symptom severity over time in people under investigation for postural orthostatic tachycardia syndrome (POTS).

Autor:	Knoop I; Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London., Jones ASK; Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London., Gall N; Cardiology Department, King's College Hospital, London., Norton S; Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London., Pascoe W; Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London., Moss-Morris R; Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London.
Jazyk:	angličtina
Zdroj:	Psychosomatic medicine [Psychosom Med] 2024 Sep 27. Date of Electronic Publication: 2024 Sep 27.
DOI:	10.1097/PSY.0000000000001346
Abstrakt:	Objective: Postural Orthostatic Tachycardia Syndrome (POTS) is a poorly understood chronic disorder characterised by an unexplained excessive increase in heartbeat upon standing. The aim of this study was to investigate psychosocial and physiological correlates and predictors of symptom severity over time in patients presenting with POTS-like symptoms. Methods: Longitudinal cohort study of patients under investigation for POTS ( n = 149). Patients completed questionnaires at one month pre-clinic appointment and 6 months later. Diagnosis, blood pressure (BP) and heart rate (HR) measures were collected from medical records. Data were analysed using hierarchical linear multiple regression. Results: Orthostatic and small fibre neuropathy (SFN) symptoms remained stable over time and were significantly correlated with distress, cardiac anxiety, threatening views of the illness, and cognitive-behavioural responses to symptoms, but not with emotional reactivity or social support. Baseline psychosocial factors collectively explained 48% (F = 5.37, p < .001) of the variance in orthostatic symptoms, and 35% (F = 3.49, p < .001) of the variance of SFN symptoms at baseline, but a non-significant amount of variance in symptoms at 6 months when controlling for baseline symptoms. Haemodynamic measures explained a significant 4% (F = 3.37, p = .026) of variance of orthostatic symptoms at 6 months. Conclusion: Symptom burden in patients with suspected POTS remained high over 6 months. Psychosocial factors explained a large amount of the variance in symptoms at baseline. As symptoms did not change/improve over time, baseline symptoms accounted for most of the variance in symptoms at 6 months. An integrated approach addressing psychosocial factors alongside medical treatments may promote adjustment to the condition and lessen symptom burden for this group. Competing Interests: Conflicts of interest and source of funding: There are no conflicts of interests to declare. Rona Moss-Morris is part funded by the Department of Health via the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health award to the South London and Maudsley NHS Foundation Trust (SLaM) and the Institute of Psychiatry at King's College London. Grant ID: 196962515. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Psychosomatic Society.)
Databáze:	MEDLINE
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