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Panic, agoraphobia, and vestibular dysfunction

R G Jacob1, J M Furman, J D Durrant

  • 1Department of Psychiatry, University of Pittsburgh School of Medicine, PA 15213, USA.

The American Journal of Psychiatry
|April 1, 1996
PubMed
Summary
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Subclinical vestibular dysfunction is common in panic disorder, especially with agoraphobia. This dysfunction may contribute to panic disorder symptoms and the development of agoraphobia.

Area of Science:

  • Otoneurology
  • Psychiatry
  • Vestibular System

Background:

  • Otoneurological abnormalities are increasingly reported in patients with panic disorder.
  • Vestibular dysfunction may play a role in the complex symptoms experienced by individuals with panic disorder.

Purpose of the Study:

  • To determine the prevalence of otoneurological findings in panic disorder with and without agoraphobia.
  • To investigate the association between vestibular dysfunction and specific symptoms in panic disorder.

Main Methods:

  • Clinical audiological and vestibular tests were performed on patients with panic disorder (with and without agoraphobia), anxiety disorders, depressive disorders, and healthy controls.
  • Evaluators were blinded to diagnostic groups, and quantitative measures of space/motion discomfort and symptom frequency were collected.

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  • Anxiety levels were assessed during vestibular testing.

    • Main Results:

    • Vestibular abnormalities were prevalent across all groups, most notably in panic disorder patients with moderate to severe agoraphobia.
    • Vestibular dysfunction correlated with space and motion discomfort and symptom frequency between panic attacks.
    • Compensated peripheral vestibular dysfunction was identified as a potential indicator specific to agoraphobia.

    Conclusions:

    • Subclinical vestibular dysfunction, detectable through clinical testing, may contribute to the phenomenology of panic disorder.
    • Vestibular dysfunction appears particularly relevant to the development of agoraphobia in individuals with panic disorder.