Psychiatric and Otologic Diagnoses in Patients Complaining of Dizziness

Abstract

Psychiatric diagnoses are common among patients with dizziness referred for otologic evaluation who do not show evidence of a peripheral vestibular disorder. Specific psychiatric disorders should be part of the differential diagnosis of patients who present with dizziness.

Medically unexplained physical symptoms in medical practice: a psychiatric perspective.

“…Some of the evidence on validity is cited below. There are, in fact, more than 10 published peer-reviewed articles relating to the external validity of the abridged somatization construct (Andreski et al 1998;Canino et al 1987;Escobar et al 1992Escobar et al , 1998bGarcia-Campayo et al 1998;Golding 1994;Gureje et al 1997;Hiller et al 1995;Johnson et al 1996;Kapoor et al 1995;Katon et al 1991;Kroenke et al 1998;Labott et al 1996;Smith et al 1995;Sullivan et al 1993;Walker et al 1995). The prevalence of high levels of unexplained physical symptoms measured by the abridged construct is in the range of 20% in primary clinics worldwide, and it is persistent in about 50% of those subjects (Gureje and Simon 1999).…”

“…A number of studies in primary care have used the abridged somatization construct as the basis for designating a case of somatization (Escobar et al 1998b;Gureje et al 1997;Katon et al 1991;Smith et al 1995;Sullivan et al 1993). This strategy has been recommended as a way to promote collaborations, refine definitions, and enhance generalization of research findings in primary care settings (Katon et al 1991).…”

“…Ear, Nose, and Throat Clinics Sullivan et al (1993) studied patients referred to a private otolaryngology practice for evaluation of a persistent complaint of dizziness. In this patient population, meeting criteria for abridged somatization predicted psychiatric rather than medical co-morbidity.…”

Tontura associada a distúrbio do pânico e agorafobia: relato de caso e revisão da literatura

“…11 Another study with 75 patients with dizziness revealed that those without vestibular disorder had a significantly higher rate of developing panic spells during their lives. 12 Jacob et al 13 reported that vestibular symptoms during panic spells are not necessarily related to the presence of vestibular dysfunction objectively identifiable; nonetheless, patients with panic disorder associated with agoraphobia have significantly more vestibular disorders than other patients. Clark 14 et al studied a self-help group for dizziness with 103 patients.…”

Anxiety in Vestibular Disorders

“…Specific psychiatric disorders should be part of the differential diagnosis of patients who present with dizziness. (Sullivan et al, 1993) A high degree of psychiatric disorders has repeatedly been described among patients with organic vertigo syndromes and attributed to vestibular dysfunction. According to EckhardtHenn's data patients with vestibular migraine and Ménière's disease showed significantly higher prevalence of psychiatric co-morbidity (MD = 57%, VM = 65%) especially with anxiety and depressive disorders, than patients with VN (22%) and BPPV (15 %) compared to normal subjects (20 %).…”