Predictive and protective factors in suicidal behavior among males diagnosed with postural tachycardia syndrome

Background: Postural orthostatic tachycardia syndrome (POTS) is a chronic invisible illness characterized by orthostatic intolerance and increased heart rate upon standing (>30 beats per minute in adults and >40 beats per minute in adolescents). This study seeks to characterize the psychological distress in males who have been diagnosed with POTS. Males are diagnosed at much lower rates than females and are underrepresented in the literature.

Methods: Forty-one male POTS patients responded to an online survey including the following instruments: acquired capability for suicide—fearlessness about death, beck depression inventory-II, interpersonal needs questionnaire-15, and the suicide behaviors questionnaire-revised.

Results: In this study, 58.5% of men surveyed scored in high-risk group for suicide on the suicide behaviors questionnaire-revised. In a multiple linear regression analysis, perceived burdensomeness (β = 0.72; p = 0.001), age (β = –0.41; p = 0.001), changes in health due to chronic illness (β = –0.39; p = 0.05) and fearlessness about death (β = 0.35; p = 0.01) explained 50.7% of their suicidal behavior.

Conclusions: In this small sample of men, perceived burdensomeness was the greatest predictor of suicidal behavior followed by fearlessness about death. Age and changes in health due to chronic illness seem to be protective against suicidal behavior. Therapeutic interventions, both medical and psychological, to decrease perceived burdensomeness could decrease the overall risk of suicide in men with postural orthostatic tachycardia syndrome. Fearlessness about death and increased changes in health due to chronic illness as indicators for suicidal behavior may provide an alternative approach for intervention for some men with postural orthostatic tachycardia syndrome.

Postural orthostatic tachycardia syndrome (POTS); Male; Quality of life; Perceived burdensomeness; Fearlessness about death; Suicidal behavior

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