Psychiatric comorbidity in different organic vertigo syndromes |
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Authors: | PD Dr med A Eckhardt-Henn C Best S Bense P Breuer G Diener R Tschan M Dieterich |
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Institution: | Dept. of Psychosomatic Medicine, Klinikum Stuttgart - Bürgerhospital, Tunzhoferstrasse 14-16, 70191, Stuttgart, Germany. A.Eckhardt@klinikum-stuttgart.de |
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Abstract: | Objective
A high degree of psychiatric disorders has repeatedly been described among patients with organic vertigo syndromes and attributed
to vestibular dysfunction. Yet almost no investigations exist which differentiate between various organic vertigo syndromes
with regard to psychiatric comorbidity. The following prospective, interdisciplinary study was carried out to explore whether
patients with different organic vertigo syndromes exhibit different psychological comorbidities.
Methods
68 patients with organic vertigo syndromes (benign paroxysmal positioning vertigo (BPPV) n = 20, vestibular neuritis (VN)
n = 18,Menière’s disease (MD) n = 7, vestibular migraine (VM) n = 23) were compared with 30 healthy volunteers.All patients
and control persons underwent structured neurological and neuro-otological testing. A structured diagnostic interview (-I)
(SCID-I) and a battery of psychometric tests were used to evaluate comorbid psychiatric disorders.
Results
Patients with VM and MD showed significantly higher prevalence of psychiatric comorbidity (MD = 57%, VM = 65%) especially
with anxiety and depressive disorders, than patients with VN (22%) and BPPV (15 %) compared to normal subjects (20 %). These
elevated rates of comorbidities resulted in significantly elevated odds-ratios (OR) for the development of comorbid psychiatric
disorders in general (for VM OR = 7.5, for MD OR = 5.3) and especially for anxiety disorders (for VM OR = 26.6, for MD OR
= 38.7).
Conclusion
As a consequence, a structured psychological and psychometric testing and an interdisciplinary therapy should be proceeded
in cases with complex and prolonged vertigo courses, especially in patients with VM and MD. Possible reasons of these unexpected
results in VM and MD are discussed. |
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Keywords: | vertigo dizziness psychiatric disorders anxiety depression |
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