Psychologic evolution of patients with Menière's disease in relation to therapy

The state of anxiety experienced by menieric patients indicates the importance of the psychologic component in this disease. Uncertainties as to the type of treatment that is actually curative for this disease have put doubts on the favorable outcome for patients referred for endolymphatic shunt procedures; some clinicians claim that in such cases surgery simply had a psychologic support function. To evaluate the effectiveness of such a statement, the authors have studied three groups of patients: patients who underwent surgery; patients who underwent medical treatment; and nonmenieric, otosclerotic subjects prior to surgery as a control group. The first group was further divided into subjects with and without improvement after surgery. The following personality tests were used: Minnesota Multiphase Personality Inventory, reduced version; Adjective Check List; State-Trait Anxiety Inventory; and Symptom Check List. The results relative to the whole menieric group show a tendency toward a state of dysphoria and more striking somatizations than in the otosclerotic group. In regard to the distinction between operated and nonoperated patients, the former group showed a personality with a strong neurotic trait associated with dysphoria and a state of free anxiety tending toward hypochondria. The outcome of the operation (improvement of the vertigo) does not seem to influence the personality of the subjects, even though there are signs of higher anxiety levels than in subjects without improvement.