Patient-reported outcome measures on mental health and psychosocial factors in patients with Brugada syndrome

Q: What are the key findings of this study?

Brugada syndrome patients exhibited significantly higher mental distress (GHQ-12 score 2.53 vs 1.7, P<0.001) and Type D personality prevalence (32.7% vs 21%, P<0.001) than the general population.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Brugada syndrome (n=209). Intervention: Brugada syndrome (BrS+) vs. General Belgian population norms and BrS-negative controls. Primary outcome: Mental distress measured by the 12-item General Health Questionnaire (GHQ-12) score (p=<0.001).

Q: What does this research mean for the field?

Patients with Brugada syndrome exhibit significantly higher levels of mental distress and a higher prevalence of Type D personality compared with the general population. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To assess patient-reported psychosocial outcomes and mental health in patients with Brugada syndrome compared to individuals without the syndrome and general population norms.

Stefaan Six; Peter Theuns; Pieter Libin; Ann Nowé; Luigi Pannone; Bart Bogaerts; Simon Jaxy; Catharina Olsen; Gudrun Pappaert; Isel Grau; Juan Antonio Sieira; Sonia Van Dooren; Esther Scheirlynck; Julie Nekkebroeck; Marina Mallefroy; Carlo de Asmundis; Johan J.R. Bilsen

doi:10.1093/europace/euad205

July 24, 2023EP EuropaceOpen Access

Patient-reported outcome measures on mental health and psychosocial factors in patients with Brugada syndrome

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Key result

Brugada syndrome is linked to higher mental distress and greater Type D personality prevalence.

P<0.001
n=209

Why the study?

Brugada syndrome is a hereditary arrhythmic disease associated with sudden cardiac death, but little was known about its psychosocial correlates and impacts. This study aimed to assess patient-reported psychosocial outcomes to better profile these patients and propose tailored psychosocial care.

Key Points

To assess patient-reported psychosocial outcomes and mental health in patients with Brugada syndrome compared to individuals without the syndrome and general population norms.
Recruited participants across two phases at a European reference center in Belgium: Phase 1 retrospective (confirmed BrS) and Phase 2 prospective (undergoing ajmaline testing with positive or negative results), analyzing 209 completed questionnaires (162 BrS+ and 47 BrS-).
Administered validated questionnaires measuring mental distress (GHQ-12), social support (OSSS-3), health-related quality of life (HeartQoL), Type-D personality (DS14), coping strategies (Brief-COPE), and personality traits (TIPI).
Patients with confirmed Brugada syndrome reported significantly higher mental distress on the GHQ-12 (2.53 ± 3.03) compared with the general population norm (1.7, P < 0.001), with 28.4% exhibiting high likelihood of a mental disorder (≥4 symptoms) versus 17.7% in the general population (P < 0.001).
Type D personality was significantly more prevalent in BrS+ patients (32.7%, n = 53/162) than in the general population norm (21%, P < 0.001), showing a strong positive correlation between negative affectivity and mental distress (r = 0.611, P < 0.001).
Overall mental distress did not differ between BrS+ and BrS- cohorts (2.53 ± 3.02 vs. 2.15 ± 3.16, P = 0.451), though prospectively diagnosed BrS+ patients experienced significantly higher distress than BrS- controls (4.5 ± 3.60 vs. 2.15 ± 3.16, P = 0.012).

Study Design

Type

Cross-Sectional (n=209)

Multicenter

No

PICO

P

Population

209 adults (mean age 47.5 years, 40.7% female) with confirmed Brugada syndrome (n=162) or undergoing ajmaline diagnostic testing with negative results (n=47) at a single Belgian reference center.

E

Exposure / Comparator

Brugada syndrome (BrS+) vs General Belgian population norms and BrS-negative controls

O

Primary Outcome

Mental distress measured by the 12-item General Health Questionnaire (GHQ-12) score, p=<0.001

Main Result

Absolute Event Rate: 2.53% vs 1.7%

p-value: p=<0.001

Limitations

Scores of mental well-being (GHQ-12) may have been influenced by restrictions associated with the COVID-19 pandemic.
All values were self-reported by study participants, introducing potential social desirability bias.
Single-centre registry design may limit generalizability to other settings or healthcare models.
Low response rate (35.7%) in the retrospective phase may introduce selection bias related to personality type and mental distress levels.
Cross-sectional/observational design shows correlation between Brugada syndrome and mental stress but cannot establish causality.

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Implication

Mental health screening may warrant consideration in Brugada syndrome; this observational association leaves open whether interventions improve outcomes.

Abstract

AIMS: Brugada syndrome (BrS) is a hereditary arrhythmic disease, associated with sudden cardiac death. To date, little is known about the psychosocial correlates and impacts associated with this disease. The aim of this study was to assess a set of patient-reported psychosocial outcomes, to better profile these patients, and to propose a tailored psychosocial care. METHODS AND RESULTS: Patients were recruited at the European reference Centre for BrS at Universitair Ziekenhuis Brussel, Belgium. Recruitment was undertaken in two phases: phase 1 (retrospective), patients with confirmed BrS, and phase 2 (prospective), patients referred for ajmaline testing who had an either positive or negative diagnosis. BrS patients were compared to controls from the general population. Two hundred and nine questionnaires were analysed (144 retrospective and 65 prospective). Collected patient-reported outcomes were on mental health (12 item General Health Questionnaire; GHQ-12), social support (Oslo Social Support Scale), health-related quality of life, presence of Type-D personality (Type-D Scale; DS14), coping styles (Brief-COPE), and personality dimensions (Ten Item Personality Inventory). Results showed higher mental distress (GHQ-12) in BrS patients (2.53 ± 3.03) than in the general population (P < 0.001) and higher prevalence (32.7%) of Type D personality (P < 0.001) in patients with confirmed Brugada syndrome (BrS +). A strong correlation was found in the BrS + group (0.611, P < 0.001) between DS14 negative affectivity subscale and mental distress (GHQ-12). CONCLUSION: Mental distress and type D personality are significantly more common in BrS patients compared to the general population. This clearly illustrates the necessity to include mental health screening and care as standard for BrS.

Discussion

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Cite This Study

Six et al. (2023) conducted a cross-sectional in Brugada syndrome (n=209). Brugada syndrome (BrS+) vs. General Belgian population norms and BrS-negative controls was evaluated on Mental distress measured by the 12-item General Health Questionnaire (GHQ-12) score (p=<0.001). Brugada syndrome patients exhibited significantly higher mental distress (GHQ-12 score 2.53 vs 1.7, P<0.001) and Type D personality prevalence (32.7% vs 21%, P<0.001) than the general population.

synapsesocial.com/papers/6ae4421188643adcd58f5606 https://doi.org/10.1093/europace/euad205

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Patient-reported outcome measures on mental health and psychosocial factors in patients with Brugada syndrome

Key Points

Study Design

PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Patient-reported outcome measures on mental health and psychosocial factors in patients with Brugada syndrome

Key Points

Study Design

PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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