Unexplained syncopes: What place is there for the liaison psychiatry? analysis of the first year of the interdisciplinary centre of unexplained faintness and syncopes

Jacques, Denis [UCL] Blommaert, Dominique [UCL] Gilain, Chantal [UCL] Zdanowicz, Nicolas [UCL] Ossemann, Michel [UCL]

Introduction: The diagnostic process of syncopes remains an important and complex issue. In spite of everything, it is estimated that 20 to 30% of syncopes remain unexplained. The diagnosis of psychogenic syncope is estimated at 5.5% to 14% of syncopes. A systematic psychiatric evaluation of unexplained syncopes would be strongly recommended. We present here the original care by the "Centre Interdisciplinaire des Malaises Inexpliqués et des Syncopes (Interdisciplinary Centre of Unexplained Faintness and Syncopes.)" set up by the neurology and cardiology departments associated with the ENT department. We describe the place liaison psychiatry has been able to define and its field of action. Subject and methods: After a year of operation, and on the basis of structured interviews with the "Mini International Neuropsychiatric Interview" and on a review of records, we assessed the recruitment in terms of psychiatric monitoring as well as the associated psychiatric diagnoses in patients who consulted for an unexplained syncope. Results: Of the 91 patients who have consulted the Interdisciplinary Centre of Unexplained Faintness and Syncopes in 2009, 24% have been directed towards a psychiatric evaluation. Among these, 68% suffered from an anxiety disorder, 27% from a major depressive disorder and 22% from a substance-related disorder. Discussion: We assess the interesting conditions that the Interdisciplinary Centre of Unexplained Faintness and Syncopes proposes for a liaison psychiatry activity. We note the interest in easier access to psychiatric care for a group that would not have spontaneously approached the Centre. Conclusion: Other measures of quality of care indices are still to be developed. © Medicinska naklada - Zagreb, Croatia.