Cognitions associated with anxiety in Ménière's disease

The purpose of this longitudinal study was to identify cognitions associated with anxiety and maintenance of anxiety in people with Ménière's disease.

At baseline, participants completed the Hospital Anxiety and Depression Scale (HADS), the Revised Illness Perception Questionnaire, the Dizziness Beliefs Scale, the Fear-Avoidance Beliefs Questionnaire, the Intolerance of Uncertainty Scale, and measures of demographic and illness characteristics. Participants were then randomized to a no-treatment group or to receive one of two self-help booklets, and completed the HADS again at 3-month follow-up.

After symptom severity had been controlled for, baseline anxiety was found to be associated with intolerance of uncertainty, fear-avoidance of physical activity, belief that dizziness would develop into a severe attack of vertigo, and several illness perception subscales (emotional representations, consequences, psychological causes, and perceived treatment effectiveness). Anxiety on follow-up was predicted by higher baseline levels of autonomic/somatic symptoms and intolerance of uncertainty, and by reporting less understanding of the illness. These longitudinal relationships were found in those who did and who did not receive self-help booklets.

Our findings suggest that intolerance of uncertainty is associated with anxiety in Ménière's disease. A controlled trial is needed to see whether anxiety might be reduced in Ménière's disease by helping patients tolerate and cope with uncertainty.