Persistence of Symptoms in Primary Somatoform Vertigo and Dizziness

Tschan, Regine; Best, C.; Wiltink, Jörg; Beutel, Manfred E.; Dieterich, Marianne; Eckhardt-Henn, Annegret

doi:10.1097/nmd.0b013e318288e2ad

Cited by 18 publications

(17 citation statements)

References 30 publications

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“…There was some controversy about treatment effects and prognosis in past publications ranging from very hard to treat without significant effect of treatment to benign and well-treatable disease with good prognosis in 3/4 of patients investigated over 5 years [10,16,17]. Different reasons for this discrepancy were suspected.…”

Section: Discussionmentioning

confidence: 90%

Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study

et al. 2015

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To investigate the long-term outcome of interdisciplinary treatment in a tertiary care neuro-otology institution after 2 years as part of the Dizziness and Vertigo Registry study. Risk factors associated with unfavourable outcome were assessed. 3113 consecutive patients with disorders of vertigo and dizziness were recruited prospectively between March 2010 and February 2012. Patients were clinically assessed and treated according to their diagnosis. Standardized instruments were used at baseline and at 2-year follow-up [Dizziness Handicap Inventory (DHI), Quality of Life Questionnaire, General Depression Scale, Stait-Trait Anxiety Index], as well as a custom health-related questionnaire. The primary outcome variable of this observational study was the change in DHI after 2 years. Patients suffered from phobic postural vertigo (23%), benign peripheral paroxysmal vertigo (14.4%), unilateral vestibulopathy (10.5%), central vestibular disorders (8%), Menière's disease (9.8%), vestibular migraine (6.9%), bilateral vestibulopathy (5.5%), and vestibular paroxysmia (3.1%). Mean disease duration was 4.6 ± 6.3 years. 1272 patients were available for follow-up, 1159 completed the DHI score. 72.1% of patients improved in DHI score from baseline to 2 years follow-up. Mean reduction in DHI score was 14 points (p = 0.02). Long-term outcome following diagnosis and treatment in a specialized tertiary care centre is good and persistent after 2 years. Risk factors for an unfavourable outcome were advanced age, severe disability, constant vertigo or dizziness, and concomitant back pain, while depression and anxiety did not contribute to this risk considerably.

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Section: Discussionmentioning

confidence: 90%

Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study

et al. 2015

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“…In 18 % of the cases the specialist’s diagnosis differed from the PCP’s [ 20 ]. Also, 46 % of the patients with a confirmed diagnosis of psychosomatic vertigo were nevertheless referred to specialists for further clinical examination and therapy [ 27 ]. Two percent of patients initially seen by a German PCP were sent to hospital [ 20 ].…”

Section: Results Of Individual Studiesmentioning

confidence: 99%

“…Likewise, 58 % of patients with confirmed vestibular causes of dizziness received medication [ 28 ]. Even though having received a recommendation, 20 % of the patients with psychosomatic vertigo did not receive psychotherapy, and 20 % received less than 12 sessions of outpatient psychotherapy [ 27 ].…”

Section: Results Of Individual Studiesmentioning

confidence: 99%

Health care utilization, prognosis and outcomes of vestibular disease in primary care settings: systematic review

2016

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Vertigo and dizziness are frequent complaints in primary care that lead to extensive health care utilization. The objective of this systematic review was to examine health care of patients with vertigo and dizziness in primary care settings. Specifically, we wanted to characterize health care utilization, therapeutic and referral behaviour and to examine the outcomes associated with this. A search of the MEDLINE and EMBASE databases was carried out in May 2015 using the search terms ‘vertigo’ or ‘dizziness’ or ‘vestibular and primary care’ to identify suitable studies. We included all studies that were published in the last 10 years in English with the primary diagnoses of vertigo, dizziness and/or vestibular disease. We excluded drug evaluation studies and reports of adverse drug reactions. Data were extracted and appraised by two independent reviewers; 16 studies with a total of 2828 patients were included. Mean age of patients ranged from 45 to 79 with five studies in older adults aged 65 or older. There were considerable variations in diagnostic criteria, referral and therapy while the included studies failed to show significant improvement of patient-reported outcomes. Studies are needed to investigate current practice of care across countries and health systems in a systematic way and to test primary care-based education and training interventions that improve outcomes.

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“…3,16 Anxiety arousal and depression may trigger or contribute to catastrophic thinking in patients with dizziness. 17,18 While there are no studies specific to dizziness catastrophizing, research on pain catastrophizing provides conflicting evidence about the degree to which catastrophizing overlaps with negative affect constructs (eg, anxiety and depression). 4,19 The results of some studies 20,21 on pain suggest a strong overlap between catastrophizing and negative affectivity, whereas the findings of other studies 4,22 suggest that, although associated with anxiety and depression, pain catastrophizing is a unique contributor to the subjective experience of pain intensity.…”

mentioning

confidence: 99%

Association Between Catastrophizing and Dizziness-Related Disability Assessed With the Dizziness Catastrophizing Scale

Pothier

Shah

Quilty

et al. 2018

JAMA Otolaryngol Head Neck Surg

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In this study, the DCS was a valid and reliable measure for evaluating catastrophic thinking in patients with dizziness, which was independently associated with dizziness-related disability. Future studies should investigate the influence of alleviating symptoms of catastrophizing on functional outcomes in patients with dizziness or imbalance, the results of which will help guide novel approaches to the clinical care of patients with chronic dizziness.

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Persistence of Symptoms in Primary Somatoform Vertigo and Dizziness

Cited by 18 publications

References 30 publications

Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study

Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study

Health care utilization, prognosis and outcomes of vestibular disease in primary care settings: systematic review

Association Between Catastrophizing and Dizziness-Related Disability Assessed With the Dizziness Catastrophizing Scale

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