Psychiatric symptoms in vertiginous patients

Psychiatric comorbidity is common in vertiginous patients. The risk of psychiatric disorder is increased in patients with previous mental problems, but earlier mentally healthy may develop symptoms as well. Especially in chronic phase of vertigo, psychological factors have a significant role in the morbidity.

The aim of this study was to evaluate the prevalence of psychiatric problems in vertiginous patients in a community sample.

A prospective evaluation of psychiatric symptoms based on self-rating scales [Beck Depression Inventory (BDI), Zung Anxiety Scale (SAS), DSM-IV and ICD-10 Personality Questionnaire (DIP-Q)] in a community sample of 100 vertiginous subjects in the Academic Tertiary Otolaryngology Department at the Helsinki University Hospital, Finland.

The prevalence of any psychiatric problem was 68% (68 patients); 19% had depressiveness and 12% symptoms of anxiety. Altogether 63 (63%) patients met the criteria of personality disorder. The most prevalent personality disorder was obsessive-compulsive (46 patients). Personality disorder alone seems not to affect functional capacity and is of importance only when comorbid with symptoms of anxiety and depression. The prevalence of psychiatric symptoms did not correlate with severity of vertigo symptoms or other co-occurring diseases.

The prevalence of any psychiatric symptoms was high among vertiginous patients. In the chronic phase of vertigo, it seems that vertigo symptoms themselves do not influence on subjective feelings of debilitation. Psychiatric disorders worsen the clinical picture of vertigo along a more debilitating and disabling course. Psychiatric differential diagnoses should accompany the neuro-otology diagnostic procedure in patients with a chronic state of vertigo and greater disability.