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Psychiatric consequences of vestibular dysfunction.

R G Jacob1, J M Furman

  • 1Department of Psychiatry and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA. jacob@msx.upmc.edu

Current Opinion in Neurology
|February 15, 2001
PubMed
Summary
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Anxiety and vestibular disorders frequently co-occur, impacting patient prognosis. This review explores their interconnectedness through neural pathways and suggests new management approaches for dizziness and anxiety.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Otolaryngology

Background:

  • Anxiety and dizziness are frequently co-morbid, exceeding chance occurrence.
  • This co-morbidity leads to increased patient handicap and poorer clinical outcomes.

Purpose of the Study:

  • To review the interface between vestibular disorders and anxiety disorders.
  • To explore the functional relationship and underlying neural mechanisms.
  • To present an alternative conceptualization of 'psychogenic' dizziness.

Main Methods:

  • Literature review focusing on the relationship between vestibular and anxiety disorders.
  • Analysis of functional mechanisms (somatopsychic and psychosomatic).
  • Examination of shared neural circuits, including monoaminergic pathways and parabrachial nucleus network.

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Main Results:

  • Vestibular and anxiety disorders are functionally linked via somatopsychic and psychosomatic pathways.
  • Overlapping neural circuits, including monoaminergic pathways and the parabrachial nucleus, underpin this connection.
  • The concept of 'psychogenic' dizziness is re-evaluated.

Conclusions:

  • The co-occurrence of anxiety and vestibular dysfunction is functionally and neurobiologically based.
  • A revised understanding of dizziness associated with anxiety is proposed.
  • Implications for clinical management of patients with co-morbid anxiety and vestibular disorders are discussed.