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Management Non pharmacologic Often, meal-related declines in blood pressure can be prevented by discontinuing hypotensive medications or avoiding their administration before meals. In patients with heart failure and preserved systolic function, the withdrawal of furosemide ameliorates PPH, possibly by improving diastolic ventricular filling [21]. Adjustments in the composition or size of meals may also help, although this has not been rigorously studied. Large carbohydrate meals and alcohol ingestion with meals should be avoided.

The higher the score assigned on each scale, the greater the personality disorder. The score is considered pathological when higher than 65 points. Subjects were asked to complete the MMPI-2 questionnaire alone at home and to return it to the Syncope Unit. Subsequently, the questionnaires were evaluated by Psychogenic Syncope: How Frequent Is It? 31 two expert psychologists, working "blind", by means of special software (MMPI-2 Psy-System, OS, Florence, Italy). Clinical diagnoses were formulated on the basis of the interview and the questionnaire results, in accordance with the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) [9].

Results Clinical Characteristics All of the patients participating in the study proved to be affected by recurrent vasovagal syncope, with serious injuries resulting from loss of consciousness being recorded in a large number of cases (Table 1). 05). 001), fear (56± 10 F. Giada et al. Ql). 05). The number of subjects with at least one psychiatric disorder according to the criteria of the DSM-IV was statistically higher among patients than among controls (Table 2), with a prevalence of somatization disorders and mood disorders.

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