ABSTRACT
Importance: Disorders of the autonomic nervous system are relatively common and have a significant impact on quality of life, offer very subtle diagnostic clues, and often mimic other disease processes, including certain psychiatric disorders. Pharmacologic treatment for psychiatric conditions in this group of patients can also be complicated by the pathophysiology of the various syndromes. Postural orthostatic tachycardia syndrome (POTS) is the final common pathway of a heterogenous group of underlying disorders that display similar characteristics.Observations: The current literature regarding the association between POTS and psychiatric conditions was reviewed. The literature showed an increased prevalence of mild/moderate depression and sleep disturbance in this population. Also, when psychiatric disorders occur in patients with POTS, clinicians may face challenges with regard to selecting appropriate psychopharmacologic interventions.Conclusions and Relevance: This review provides an evidence-based approach to treating common psychiatric conditions in those who suffer from POTS, with a particular emphasis on side effects that may worsen the associated symptoms. A list of the classes of psychopharmacologic treatment with a focus on adverse effects on heart rate and blood pressure is included, as is a case vignette of a patient with complex comorbid psychiatric conditions. It is of significant value to highlight the complexities associated with POTS; to raise awareness of the disorder, particularly in the context of psychiatric comorbidities; and to disseminate evidence-based information to aid clinicians in making informed medication choices with their patients.
Subject(s)
Mental Disorders , Postural Orthostatic Tachycardia Syndrome , Humans , Postural Orthostatic Tachycardia Syndrome/complications , Postural Orthostatic Tachycardia Syndrome/drug therapy , Postural Orthostatic Tachycardia Syndrome/epidemiology , Quality of Life , Comorbidity , Heart Rate/physiology , Mental Disorders/epidemiologyABSTRACT
In the meta-cognitive model of worry, positive, and negative beliefs about worry interact to make worry problematic. These beliefs have been found to be associated with anxiety in adolescents, but it is unknown whether they are associated with worry. Furthermore, it may be via cognitive mechanisms such as these, or directly through behavior, that parents influence their child's worry. The current study aimed to explore whether adolescent meta-cognition and parenting behaviors and meta-cognitions were associated with adolescent worry. Results indicated that meta-cognitions were specifically associated with worry in adolescents, but there was little evidence that parenting was. Parental worry on the other hand was associated with both parent and child reported parenting. It is concluded that the meta-cognitive model of worry may be relevant in adolescents, but that further research is required to explore how parents influence adolescent worry.
