心理療法が適応と判断された慢性めまい患者の臨床的特徴―耳鼻咽喉科診療所における検討―

Abstract

Postural-Perceptual Dizziness：PPPD)や心因性め まい(Psychogenic Vertigo)などの慢性めまいに対The effectiveness of psychotherapy as a treatment for chronic dizziness, including Persistent Postural-Perceptual Dizziness (PPPD) and Psychogenic Vertigo, has been reported. In Japan, the number of institutions that can provide psychotherapy for chronic dizziness is limited, and the current status of psychotherapy for chronic dizziness patients is not entirely clear. The purpose of this study was to clarify the clinical characteristics and outcomes of psychotherapy in patients who undergo psychotherapy, and to examine the selection criteria of patients for psychotherapy. The subjects were 18 patients who visited our clinic between January and December 2021 with chronic dizziness of more than 3 months' duration, in whom psychotherapy was indicated. The mean number of days from the first visit to the indication of psychotherapy was 33.28 ± 60.91 days. The mean Dizziness Handicap Inventory (DHI) score was 51.6, which was in the severe range, and the mean Hospital Anxiety and Depression Scale (HADS) scores were 12.1 for anxiety and 9.0 for depression, indicating high levels of both anxiety and depression. The primary diagnosis was PPPD in 9 patients and psychogenic vertigo in 9 patients. There were no significant differences in the DHI and HADS scores between the two groups. The patients with dizziness lasting for more than 1 year reported more impairment in daily functioning due to dizziness than patients with dizziness lasting for less than 1 year. Psychotherapy proved effective in 7 patients (38.9％). The results of this study suggested that cases with severe handicap, psychiatric symptoms, and impaired life function were suitable for psychotherapy. The indications and effectiveness of psychotherapy in patients with chronic dizziness were clearly revealed in this study.