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Quantitative Analysis of Psychiatric Disorders in Intractable Peripheral Vertiginous Patients: A Prospective Study
Feng Zhai1, Jing Wang, Yibo Zhang
1*Department of Otology and Skull Base Surgery, Eye and Ear Nose and Throat Hospital †Department of Otolaryngology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine ‡Hearing Research Key Lab of Health Ministry of China, Fudan University, Shanghai, China.
Objective:
To investigate the correlation between psychological disorder and vestibular dysfunction in patients suffering from intractable peripheral vertigo.
Study Design:
Prospective study.
Setting:
In-patients in a university hospital.
Methods:
Prospective design of 26 intractable peripheral vertiginous patients with peripheral vestibular dysfunction and 20 controls recruited from the EENT hospital. Hospital Anxiety and Depression scale, Self-rating Anxiety scale, Self-rating Depression scale, Symptom Checklist-90 were used in this study. All vertigo patients received intratympanic gentamicin/dexamethasone administration or endolymphatic sac decompression. Pre- and posttreatment scores were collected and compared. All the results were statistically analyzed using Stata 8.0. t test or rank-sum test and paired-sample t test or rank-sum test were performed.
Results:
The outcomes of Hospital Anxiety and Depression scale, Self-rating Anxiety scale, Self-rating Depression scale, Symptom Checklist-90 were significantly greater in vertiginous group than that in normal controls (p < 0.05). The pretreatment scores of these four scales were greater than the posttreatment scores in vertiginous patients, especially in Class A and B groups (p < 0.05). The scores of more scales were demonstrated to be statistically different in patients with over 5 years of the disorder and among patient in stages 1 to 3 than in stage 4 (p < 0.05). No significant difference was noted between male and female participants in all the questionnaires used (p > 0.05).
Conclusion:
Increased anxiety/depression levels were noted in peripheral vertiginous patients compared with normal controls through psychiatric questionnaires, and then a significant decrease after the effective treatment of vertigo, suggesting that vertigo attack may contribute to psychological dysfunction. The intervention seemed to be more effective in lowering anxiety/depression levels among patients in earlier stage of Ménière's disease marked by pure-tone audiometry results.
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