Cognitive-behavioural therapy for chronic subjective dizziness: Predictors of improvement in Dizziness Handicap Inventory at 6 months posttreatment

Toshishige, Yuko; Kondo, Masaki; Kabaya, Kayoko; Watanabe, Wakako; Fukui, Akifumi; Kuwabara, Junya; Nakayama, Meiho; Iwasaki, Shinichi; Furukawa, Toshi A; Akechi, Tatsuo

doi:10.1080/00016489.2020.1772994

Cited by 15 publications

(8 citation statements)

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“…The prevalence of anxiety in PPPD has been the focus of one of the treatment modalities, namely cognitive behavioral therapy (CBT) (32). Toshishige et al (33) have recently demonstrated in a study of 34 patients with PPPD that the presence of comorbid anxiety disorders predicted a considerable improvement of DHI scores from pre-treatment to 6-month following CBT (33). Our data showed a significant difference in anxiety levels between PPPD cases and non-dizzy controls.…”

Section: Discussionsupporting

confidence: 58%

Assessment of Potential Risk Factors for the Development of Persistent Postural-Perceptual Dizziness: A Case-Control Pilot Study

et al. 2021

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Objectives: (1) To assess whether neuroticism, state anxiety, and body vigilance are higher in patients with persistent postural-perceptual dizziness (PPPD) compared to a recovered vestibular patient group and a non-dizzy patient group; (2) To gather pilot data on illness perceptions of patients with PPPD.Materials and Methods: 15 cases with PPPD and two control groups: (1) recovered vestibular patients (n = 12) and (2) non-dizzy patients (no previous vestibular insult, n = 12). Main outcome measures: Scores from the Big Five Inventory (BFI) of personality traits, Generalized Anxiety Disorder - 7 (GAD-7) scale, Body Vigilance Scale (BVS), Dizziness Handicap Inventory (DHI), modified Vertigo Symptom Scale (VSS) and Brief Illness Perception Questionnaire (BIPQ).Results: Compared to non-dizzy patients, PPPD cases had higher neuroticism (p = 0.02), higher introversion (p = 0.008), lower conscientiousness (p = 0.03) and higher anxiety (p = 0.02). There were no differences between PPPD cases and recovered vestibular patients in BFI and GAD-7. PPPD cases had higher body vigilance to dizziness than both control groups and their illness perceptions indicated higher levels of threat than recovered vestibular patients.Conclusion: PPPD patients showed statistically significant differences to non-dizzy patients, but not recovered vestibular controls in areas such as neuroticism and anxiety. Body vigilance was increased in PPPD patients when compared with both recovered vestibular and non-dizzy patient groups. PPPD patients also exhibited elements of negative illness perception suggesting that this may be the key element driving the development of PPPD. Large scale studies focusing on this area in the early stages following vestibular insult are needed.

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Section: Discussionsupporting

confidence: 58%

Assessment of Potential Risk Factors for the Development of Persistent Postural-Perceptual Dizziness: A Case-Control Pilot Study

et al. 2021

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“…Published studies of all three existing treatment modalities for PPPD and its predecessors, namely vestibular rehabilitation,47 medication48 and psychotherapy,44 hint that early therapeutic intervention outcomes are more effective. One study examining positive predictors of CBT effectiveness in the long-term found that the presence or absence of comorbid anxiety disorders was the most significant positive predictive factor for improvement of DHI at 6-month follow-up 49. Another study analysing visual rehabilitation in 27 patients with PPPD found that after 6 months, 41% achieved remission and 74% achieved remission and/or treatment response 50…”

Section: Discussionmentioning

confidence: 99%

Predictors of persistent postural-perceptual dizziness (PPPD) and similar forms of chronic dizziness precipitated by peripheral vestibular disorders: a systematic review

Trinidade

Cabreira

Goebel

et al. 2023

J Neurol Neurosurg Psychiatry

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BackgroundThe literature on predictors of persistent postural-perceptual dizziness (PPPD) following peripheral vestibular insults has not been systematically reviewed.MethodsWe systematically reviewed studies on predictors of PPPD and its four predecessors (phobic postural vertigo, space-motion discomfort, chronic subjective dizziness and visual vertigo). Investigations focused on new onset chronic dizziness following peripheral vestibular insults, with a minimum follow-up of 3 months. Precipitating events, promoting factors, initial symptoms, physical and psychological comorbidities and results of vestibular testing and neuroimaging were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsWe identified 13 studies examining predictors of PPPD or PPPD-like chronic dizziness. Anxiety following vestibular injury, dependent personality traits, autonomic arousal and increased body vigilance following precipitating events and visual dependence, but not the severity of initial or subsequent structural vestibular deficits or compensation status, were the most important predictors of chronic dizziness. Disease-related abnormalities of the otolithic organs and semi-circular canals and age-related brain changes seem to be important only in a minority of patients. Data on pre-existing anxiety were mixed.ConclusionsAfter acute vestibular events, psychological and behavioural responses and brain maladaptation are the most likely predictors of PPPD, rather than the severity of changes on vestibular testing. Age-related brain changes appear to have a smaller role and require further study. Premorbid psychiatric comorbidities, other than dependent personality traits, are not relevant for the development of PPPD.

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“…32 Disorders such as unilateral and bilateral vestibulopathy and postural perceptual persistent dizziness, would benefit from vestibular rehabilitation and cognitive behavioral therapy, as well as other alternatives with diverse levels of evidence such as Tai Chi, acupuncture and Lian Gong. [37][38][39] These strategies are mainly focused on the improvement of physical ad functional impairment given by the vestibular disorders, but further work is needed on the treatment of emotional and mental health collateral conditions. [40][41][42] This review is an overview of how vestibular disorders may affect the QoL of patients and is one of the first studies focused on describing in each vestibular disorder.…”

Section: Results and Implicationsmentioning

confidence: 99%

Quality of life in patients with vestibular disorders: a narrative review

Franco

Uricel

Valencia

et al. 2023

Int J Otorhinolaryngol Head Neck Surg

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Vestibular disorders may lead to physical disability and altered quality-of life. Even though, some specific diseases are associated with sleep, work, leisure, and emotional impairment, little is known about which vestibular disorders may lead to disturbances in daily life activities. We aim to extend the understanding of this issue and provide a comprehensive overview about how vestibular disorders are linked to altered quality of life (QoL). Currently available literature was analysed for understanding the affection of QoL in several focused daily-life activities. Vestibular disorders and QoL articles were reviewed; 431 articles were found on different databases and 50 were included in this review. We provide the latest evidence about how QoL is affected by vestibular disorders, their relationship, and upcoming challenges in this review. The deepest understanding of how QoL may be affected by vestibular disorders would provide better comprehension of this process for primary care physicians, otolaryngologists, neurologists, and neuro-otologists.

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Cognitive-behavioural therapy for chronic subjective dizziness: Predictors of improvement in Dizziness Handicap Inventory at 6 months posttreatment

Cited by 15 publications

References 15 publications

Assessment of Potential Risk Factors for the Development of Persistent Postural-Perceptual Dizziness: A Case-Control Pilot Study

Assessment of Potential Risk Factors for the Development of Persistent Postural-Perceptual Dizziness: A Case-Control Pilot Study

Predictors of persistent postural-perceptual dizziness (PPPD) and similar forms of chronic dizziness precipitated by peripheral vestibular disorders: a systematic review

Quality of life in patients with vestibular disorders: a narrative review

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