Biopsychosocial factors associated with distress in people with suspected postural orthostatic tachycardia syndrome (POTS): A longitudinal regression and correlation study.

PURPOSE: Postural Orthostatic Tachycardia Syndrome (POTS) is a debilitating condition of the autonomic nervous system with no clear referral, diagnosis, and treatment pathways. Patients experience high levels of symptoms and moderate levels of distress. The purpose of this study was to explore biopsychosocial factors associated with distress in those under investigation for POTS, to identify potential targets for intervention.

METHODS

A longitudinal, quantitative survey. Participants (n = 149) completed demographic, psychosocial, and symptom questionnaires prior to a diagnostic POTS clinic visit and 6 months follow-up (n = 98). Correlation and regression analyses were used to identify factors associated with distress at baseline (within one month before diagnostic hospital visit) and at 6 months follow up.

RESULTS

At baseline, distress levels were moderate and greater symptom focusing, all-or-nothing and avoidance behaviours, threatening views of the illness, emotional reactivity, cardiac anxiety, POTS symptoms, number of specialists seen, lower social support, and younger age were significantly associated with higher levels of baseline distress. The baseline regression model including all demographic, clinical, and psychosocial factors explained 61.2 % of the variance in distress, with the psychosocial variables collectively explaining 55.6 % of this variance (F = 11.06, p < .001). There was no significant difference between distress levels at baseline and follow-up. Psychosocial variables explained 4.7 % of the variance (F = 0.76, p = .665) in changes in distress scores over 6 months. Baseline distress scores accounted for the vast majority of variance in distress at follow-up.

CONCLUSIONS

This study identified key novel psychosocial factors that were significantly associated with distress which could be potential targets for intervention. Additional factors such as younger age and a higher number of specialists seen were also associated with higher levels of distress, which merits attention when assessing patients' psychological wellbeing this patient group. Distress levels did not significantly change following the specialist consultation and investigation.