TY - JOUR
T1 - Correlates and predictors of symptom severity over time in people under investigation for postural orthostatic tachycardia syndrome (POTS)
AU - Knoop, Iris
AU - Jones, Annie S K
AU - Gall, Nicholas
AU - Norton, Sam
AU - Pascoe, William
AU - Moss-Morris, Rona
N1 - Publisher Copyright:
© 2024 Lippincott Williams and Wilkins. All rights reserved.
PY - 2024/11/11
Y1 - 2024/11/11
N2 - Objective Postural orthostatic tachycardia syndrome (POTS) is a poorly understood chronic disorder characterized 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 1 month preclinic appointment and 6 months later. Diagnosis, blood pressure (BP), and heart rate (HR) measures were collected from medical records. Data were analyzed using hierarchical linear multiple regression. Results Orthostatic and small fiber neuropathy (SFN) symptoms remained stable over time and were significantly correlated with distress, cardiac anxiety, threatening views of the illness, and cognitive-behavioral 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 nonsignificant amount of variance in symptoms at 6 months when controlling for baseline symptoms. Hemodynamic 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.
AB - Objective Postural orthostatic tachycardia syndrome (POTS) is a poorly understood chronic disorder characterized 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 1 month preclinic appointment and 6 months later. Diagnosis, blood pressure (BP), and heart rate (HR) measures were collected from medical records. Data were analyzed using hierarchical linear multiple regression. Results Orthostatic and small fiber neuropathy (SFN) symptoms remained stable over time and were significantly correlated with distress, cardiac anxiety, threatening views of the illness, and cognitive-behavioral 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 nonsignificant amount of variance in symptoms at 6 months when controlling for baseline symptoms. Hemodynamic 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.
KW - postural orthostatic tachycardia syndrome
KW - POTS
KW - biopsychosocial predictors
KW - regression analysis
KW - long-term conditions
KW - integrated medicine
UR - http://www.scopus.com/inward/record.url?scp=85205042404&partnerID=8YFLogxK
U2 - 10.1097/PSY.0000000000001346
DO - 10.1097/PSY.0000000000001346
M3 - Article
SN - 0033-3174
VL - 86
SP - 800
EP - 809
JO - Psychosomatic medicine
JF - Psychosomatic medicine
IS - 9
M1 - 10.1097/PSY.0000000000001346
ER -