Family Relationships and Personality Traits of Postural Tachycardia Syndrome

Meiko Matsui ^1* Seiji Yoshida ¹ Hidetaka Tanaka ² Ginroku Yamawake ¹ Yusuke Kurooka ¹ Yoshitaka Ohta ³ Atsuko Kubo ⁴ Midori Mizutani ⁵ Akira Ashida ¹

• ¹ Osaka Medical and Pharmaceutical University, Takatsuki, Japan
• ² OD Hypotension Clinic Tanaka, Osaka, Japan
• ³ Saiseikai Suita Hospital, Suita, Japan
• ⁴ Saiseikai Ibaraki Hospital, Ibaraki, Japan
• ⁵ Hokusetsu General Hospital, Takatsuki, Japan

Introduction: Orthostatic intolerance is the name of the disease in Europe and the United States; however, it is commonly known as orthostatic dysregulation (OD) in Japan. OD is a physical disorder caused by failure of the body's compensatory regulatory mechanism to adapt to changes in circulatory dynamics during orthostasis, although in many cases the influence of psychosocial factors has been noted. The mother-child relationship is a major psychosocial factor in children, and it has been reported that parent-child patterns associated with OD are often excessive parental interference and child over-adaptation. This study focused on the psychological and physical factors of OD and assessed the parent-child relationship patterns among children with postural tachycardia syndrome (POTS), a subtype of OD, and examined how they relate to the child's personality traits and autonomic neuron function. Methods: Thirty-six children diagnosed with POTS (mean age: 13.5 ± 0.9 years) were compared with the results of the following questionnaires on parent-child relationships, personality traits, and the autonomic neuron function test: Family Diagnostic Test (a diagnostic test of parent-child relationship) for mothers and children, and AN-EGOGRAM (the egograms that can be adapted to childhood and adolescence, when the ego is in the process of developing and growing), and a frequency analysis of heartrate and blood pressure variability for the children. Results: Assessment of the mother-child relationship patterns among children with POTS and found significant association between maternal "strict discipline" and children's negative feelings, between excessive parental intervention and children's susceptibility to stress, and between the degree of children's "feeling of rejection" and lower supine vasomotor sympathetic nerve activity. The findings also suggested that the personality traits of children with POTS included lower CP (critical parent) and FC (free child), and higher AC (adapted child), and that mothers of children with high AC were less dissatisfied with their spouses about childcare. Discussion: In the parentchild relationship in POTS, there is an association between maternal "strict discipline" and children's negative feelings, suggesting that a lower degree of strict discipline is considered to build a better parent-child relationship.