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Anxiety and Depression in Adults With Vestibular Disorders: A Systematic Review and Meta-Analysis
Cory Hyun-Su Kim1,2, Lauren R McCray1,3, Shaun A Nguyen1
1Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
The Laryngoscope
|August 15, 2025
Summary
Patients with vestibular disorders have significantly higher rates of anxiety and depression compared to controls. This meta-analysis provides precise estimates, highlighting the increased risk in episodic conditions and informing understanding of vestibular-psychiatric comorbidity.
Area of Science:
- Neurology
- Psychiatry
- Epidemiology
Background:
- Vestibular disorders are common and can significantly impact quality of life.
- Anxiety and depressive disorders are frequently observed comorbidities in patients with vestibular conditions.
- Precise prevalence estimates are needed to understand the burden of these psychiatric comorbidities.
Purpose of the Study:
- To derive precise prevalence and relative risk estimates of anxiety and depressive disorders in adults with common vestibular disorders.
- To compare comorbidity rates between different types of vestibular disorders and with control populations.
- To explore associations between vestibular disorder severity and psychiatric symptoms.
Main Methods:
- A systematic review and meta-analysis was conducted following PRISMA guidelines.
- Searches were performed across major databases including PubMed, PsycINFO, CINAHL, SCOPUS, and Cochrane Library.
- Data from 85 studies encompassing 764,403 adults were analyzed, calculating proportions, means, and relative risks with 95% confidence intervals.
Main Results:
- Patients with vestibular disorders exhibited significantly higher rates of anxiety (31.4% vs. 8.3%) and depression (28.3% vs. 4.7%) compared to controls.
- Elevated prevalence was noted in benign paroxysmal positional vertigo, Meniere's disease, and vestibular migraine, with episodic disorders showing higher rates than vestibular neuritis.
- Significant associations were found between Dizziness Handicap Inventory (DHI) scores and Hospital Anxiety and Depression Scale (HADS) subscales.
Conclusions:
- This meta-analysis provides the most precise estimates to date for anxiety and depression prevalence in vestibular disorders.
- The heightened risk observed in episodic vestibular disorders suggests distinct pathophysiological mechanisms for vestibular-psychiatric comorbidity.
- Findings underscore the importance of screening for and managing anxiety and depression in patients with vestibular conditions.
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