P-wave and QT dispersion in patients with conversion disorder
Authors Izci F, Hocagil H, Izci S, Izci V, Iris Koc M, Acar RD
Received 30 January 2015
Accepted for publication 12 February 2015
Published 26 March 2015 Volume 2015:11 Pages 475—480
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Garry Walsh
Filiz Izci,1 Hilal Hocagil,2 Servet Izci,3 Vedat Izci,4 Merve Iris Koc,5 Rezzan Deniz Acar3
1Department of Psychiatry, Istanbul Bilim University, Sisli Florence Nightingale Hospital; 2Department of Emergency, Faculty of Medicine Hospital Zonguldak Bulent Ecevit University, Zonguldak, Turkey; 3Department of Cardiology, Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey; 4Department of Emergency, Kartal Training and Research Hospital, Istanbul, Turkey; 5Department of Psychiatry, Erenköy Training and Research Hospital for Psychiatry, Istanbul, Turkey
Objective: The aim of this study was to investigate QT dispersion (QTd), which is the noninvasive marker of ventricular arrhythmia and sudden cardiac death, and P-wave dispersion, which is the noninvasive marker of atrial arrhythmia, in patients with conversion disorder (CD).
Patients and methods: A total of 60 patients with no known organic disease who were admitted to outpatient emergency clinic and were diagnosed with CD after psychiatric consultation were included in this study along with 60 healthy control subjects. Beck Anxiety Inventory and Beck Depression Scale were administered to patients and 12-lead electrocardiogram measurements were obtained. Pd and QTd were calculated by a single blinded cardiologist.
Results: There was no statistically significant difference in terms of age, sex, education level, socioeconomic status, weight, height, and body mass index between CD patients and controls. Beck Anxiety Inventory scores (25.2±10.8 and 3.8±3.2, respectively, P<0.001) and Beck Depression Scale scores (11.24±6.15 and 6.58±5.69, respectively, P<0.01) were significantly higher in CD patients. P-wave dispersion measurements did not show any significant differences between conversion patients and control group (46±5.7 vs 44±5.5, respectively, P=0.156). Regarding QTc and QTd, there was a statistically significant increase in all intervals in conversion patients (416±10 vs 398±12, P<0.001, and 47±4.8 vs 20±6.1, P<0.001, respectively).
Conclusion: A similar relation to that in literature between QTd and anxiety and somatoform disorders was also observed in CD patients. QTc and QTd were significantly increased compared to the control group in patients with CD. These results suggest a possibility of increased risk of ventricular arrhythmia resulting from QTd in CD patients. Larger samples are needed to evaluate the clinical course and prognosis in terms of arrhythmia risk in CD patients.
Keywords: ECG, arrhythmia, conversion disorder
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