Kakavand Bahram, Centner Aliya, Centner Safia, Hasan Shirin
Pediatric Cardiology, Nemours Children's Health System, Orlando, USA.
Medicine, University of Central Florida College of Medicine, Orlando, USA.
Cureus. 2024 Sep 22;16(9):e69941. doi: 10.7759/cureus.69941. eCollection 2024 Sep.
Postural orthostatic tachycardia syndrome (POTS) is a chronic form of orthostatic intolerance characterized by various symptoms such as dizziness, lightheadedness, and increased heart rate. Conflicting reports exist regarding the prevalence of anxiety and depression in adults with POTS, while data on pediatric POTS remains scarce.
A retrospective analysis of pediatric patients aged 11-17 years with POTS, who underwent autonomic testing at Nemours Children's Hospital in Orlando, Florida, was conducted. The patients were screened for anxiety, using the Severity Measure for Generalized Anxiety Disorder-Child Age 11-17 years (GAD-7) questionnaire, and depression, using PHQ-9 Modified for Adolescence (PHQ-A) for depression. The prevalence rates of anxiety and depression in the study cohort were compared to historical data from similar age groups in the existing literature. The study was approved by the Nemours Children's Hospital Institutional Review Board.
The cohort comprised 27 children with POTS (26 females, age 15.8±1.6 years). Overall, 74% exhibited moderate-to-severe anxiety, depression, or both, with 44% having comorbid anxiety and depression. In total, 4/27 (14%) had pure depression and 4/27 (14%) had pure anxiety. Six patients had no depression or anxiety. On average, POTS symptoms began 1.9±1.3 years before diagnosis. Eleven patients took stable doses of psychotropic medications. After a follow-up period of 5.1±1.7 months of POTS therapy, seven patients had follow-up questionnaires. In 4/7 patients, the depression severity improved, and in 3/7 patients, the anxiety severity improved. Patients were not actively treated for depression and anxiety during this time.
Anxiety and depression are prevalent among pediatric patients with POTS. While preliminary data suggests POTS therapy may alleviate these psychological symptoms, further longitudinal studies are warranted to explore the therapeutic impact in greater detail.
体位性直立性心动过速综合征（POTS）是一种慢性直立不耐受形式，其特征为头晕、眩晕和心率加快等多种症状。关于成人POTS患者焦虑和抑郁的患病率存在相互矛盾的报道，而关于儿童POTS的数据仍然稀缺。
对11至17岁在佛罗里达州奥兰多市Nemours儿童医院接受自主神经测试的POTS儿科患者进行回顾性分析。使用11 - 17岁儿童广泛性焦虑障碍严重程度量表（GAD - 7）问卷对患者进行焦虑筛查，并使用青少年版改良PHQ - 9（PHQ - A）进行抑郁筛查。将研究队列中焦虑和抑郁的患病率与现有文献中相似年龄组的历史数据进行比较。该研究获得了Nemours儿童医院机构审查委员会的批准。
该队列包括27名POTS儿童（26名女性，年龄15.8±1.6岁）。总体而言，74%的患者表现出中度至重度焦虑、抑郁或两者兼有，44%的患者同时患有焦虑和抑郁。总共有4/27（14%）的患者患有单纯性抑郁，4/27（14%）的患者患有单纯性焦虑。6名患者既没有抑郁也没有焦虑。平均而言，POTS症状在诊断前1.9±1.3年出现。11名患者服用稳定剂量的精神药物。在POTS治疗5.1±1.7个月的随访期后，7名患者有随访问卷。在4/7的患者中，抑郁严重程度有所改善，在3/7的患者中，焦虑严重程度有所改善。在此期间，患者未接受针对抑郁和焦虑的积极治疗。
焦虑和抑郁在患有POTS的儿科患者中很普遍。虽然初步数据表明POTS治疗可能会缓解这些心理症状，但仍需要进一步的纵向研究来更详细地探讨治疗效果。
