Health-related quality of life and emotional distress in patients with dizziness: a cross-sectional approach to disentangle their relationship

Abstract

BackgroundDizziness is frequently encountered in medical practice, often takes a chronic course and can impair the health related quality of life (HRQoL). However results on the extent of this impairment of HRQoL are mixed. Furthermore, the relationship between dizziness and the HRQoL is only partially understood. The role of clinical symptoms of dizziness and psychosocial factors such as emotional distress on this relationship is for the most part unknown.MethodsThe cross-sectional study evaluated the HRQoL in 203 patients suffering from dizziness, using the Medical Outcomes Studies 36-Item Short-Form Health-Survey (SF-36). The results were correlated with the severity of dizziness, using the Dizziness Handicap-Inventory (DHI), with emotional distress, using the Hospital Anxiety and Depression-Scale (HADS) and with further clinical symptoms and psychosocial parameters. In a multivariate hierarchical regression analysis associated variables which explain significant variance of the mental and physical HRQoL (MCS-36, PCS-36) were identified.ResultsPatients suffering from dizziness showed a markedly reduced mental and physical HRQoL. Higher DHI and HADS scores were correlated with lower MCS-36 and PCS-36 scores. Taken together DHI and vertigo characteristics of dizziness explained 38% of the variance of PCS-36. Overall explained variance of PCS-36 was 45%. HADS and living with a significant other explained 66% of the variance of MCS-36 (overall variance explained: 69%).ConclusionBoth the physical and mental HRQoL are significantly impaired in patients with dizziness. While the impairment in PCS-36 can be explained by clinical symptoms of the dizziness, MCS-36 impairment is largely associated with psychosocial factors. To improve the patient’s overall well-being significantly and permanently doctors have to keep in mind both, the clinical symptoms and the psychosocial factors. Therefore, in addition to the physical examination doctors should integrate a basic psychological examination into the daily routine with dizziness patients.

Impacts of small vestibular schwannoma on community ambulation, postural, and ocular control

“…Although the DHI scores for the clinical group were significantly higher than controls, the mean score for the clinical group suggests that the impact of dizziness on quality of life was relatively mild for most participants. Each subcategory score (physical, functional, and emotional) was higher than controls, and some people with VS were moderately (36–62) impacted by symptoms, consistent with other vestibular disorders . These findings are not surprising, as people with vestibular disorders may have abnormal sensitivity to motion .…”

“…Each subcategory score (physical, functional, and emotional) was higher than controls, and some people with VS were moderately (36-62) impacted by symptoms, consistent with other vestibular disorders. 18,[31][32][33] These findings are not surprising, as people with vestibular disorders may have abnormal sensitivity to motion. 18 If persistent symptoms contribute to distress or depression, counseling is indicated in addition to management of physical and functional deficits.…”

The Effectiveness of Vestibular Rehabilitation Interventions in Treating Unilateral Peripheral Vestibular Disorders: A Systematic Review

“…Dizziness symptoms were reported in 1 out of 5 individuals of working age (Yardley et al, 1998). It is reported that health-related quality of life, both mental and physical, is significantly impaired in those with dizziness (Weidt et al, 2014). Although dizziness can be caused by a variety of medical conditions, it is estimated that 50% of cases are due to vestibular dysfunction (Hall and Cox, 2009).…”

Health‐related quality of life and economic burden of vestibular loss in older adults

“…Despite the greater prevalence of vestibular loss in older adults and its associated functional limitations, the quality of life (QoL) burden of vestibular loss in this vulnerable population has not been well-studied. The few studies that have reported QoL outcomes considered the broader symptom of dizziness rather than specifically vestibular physiologic impairment, 7,[11][12][13][14][15] did not have a normative-age-matched comparison group available, 11 or were conducted across a broad age range including younger age groups. 7,13,16 In this report, we quantify the independent impact of vestibular physiologic loss on overall QoL and identify domains of health including vision, hearing, speech, ambulation, dexterity, emotion, cognition, and pain affected by this condition in a sample of older adults with vestibular loss seen in a Neurotology clinic.…”