Psychiatric conditions in patients presenting with Takotsubo syndrome: A systematic review and synthesis of case studies

The purpose of this systematic review was to describe psychiatric presentations observed among Takotsubo syndrome (TS) patients, how psychiatric conditions and associated treatments impact TS events, and how psychiatric conditions are managed alongside TS medical treatment and follow-up. We searched...

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Bibliographic Details
Published in:General hospital psychiatry 2020-07, Vol.65, p.54-63
Main Authors: Carroll, Allison J., Goergen, Jack, Wafford, Q. Eileen, Flaherty, James D., Grady, Kathleen L., Feingold, Kim L.
Format: Article
Language:English
Subjects:
Psychiatric treatment
Psychopathology
Substance use
Systematic review
Takotsubo syndrome
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Summary:The purpose of this systematic review was to describe psychiatric presentations observed among Takotsubo syndrome (TS) patients, how psychiatric conditions and associated treatments impact TS events, and how psychiatric conditions are managed alongside TS medical treatment and follow-up. We searched MEDLINE, Cochrane Database of Systematic Reviews, Embase, PsycInfo, CINAHL, and Web of Science between 1990 and 2019 for case reports of TS with comorbid psychiatric conditions, behaviors, or substance use. Of 2403 records, we included 243 records comprising 252 total cases. Common psychiatric conditions included depression (n = 98; 39%), anxiety (n = 44, 17%), alcohol use (n = 35, 14%), suicidality (n = 30, 12%), and severe mental illness (n = 25, 10%). Psychiatric conditions were frequently associated with triggering TS events (61%). Less than one-third of cases reported providing psychiatric care during hospitalization (n = 80, 32%). Only 33 cases (13%) described psychiatric functioning at follow-up. All case studies were assessed to be of low quality; patterns of reporting bias were observed. Despite heterogeneous psychiatric presentations among TS patients, psychiatric treatment was rarely incorporated into the medical care or addressed at follow-up. This gap may be better attended to by integrating psychiatrists and psychologists into the multidisciplinary treatment team. CRD42019119998. •Psychiatric conditions and behaviors can trigger Takotsubo syndrome.•Presentations of psychiatric conditions, behaviors, and substance use varied widely.•Psychiatric treatment was rarely addressed in medical management of these patients.
ISSN:0163-8343
1873-7714
DOI:10.1016/j.genhosppsych.2020.05.010