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Psychiatric comorbidity in different organic vertigo syndromes

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Abstract

Objective

A high degree of psychiatric disorders has repeatedly been described among patients with organic vertigo syndromes and attributed to vestibular dysfunction. Yet almost no investigations exist which differentiate between various organic vertigo syndromes with regard to psychiatric comorbidity. The following prospective, interdisciplinary study was carried out to explore whether patients with different organic vertigo syndromes exhibit different psychological comorbidities.

Methods

68 patients with organic vertigo syndromes (benign paroxysmal positioning vertigo (BPPV) n = 20, vestibular neuritis (VN) n = 18,Menière’s disease (MD) n = 7, vestibular migraine (VM) n = 23) were compared with 30 healthy volunteers.All patients and control persons underwent structured neurological and neuro-otological testing. A structured diagnostic interview (-I) (SCID-I) and a battery of psychometric tests were used to evaluate comorbid psychiatric disorders.

Results

Patients with VM and MD showed significantly higher prevalence of psychiatric comorbidity (MD = 57%, VM = 65%) especially with anxiety and depressive disorders, than patients with VN (22%) and BPPV (15 %) compared to normal subjects (20 %). These elevated rates of comorbidities resulted in significantly elevated odds-ratios (OR) for the development of comorbid psychiatric disorders in general (for VM OR = 7.5, for MD OR = 5.3) and especially for anxiety disorders (for VM OR = 26.6, for MD OR = 38.7).

Conclusion

As a consequence, a structured psychological and psychometric testing and an interdisciplinary therapy should be proceeded in cases with complex and prolonged vertigo courses, especially in patients with VM and MD. Possible reasons of these unexpected results in VM and MD are discussed.

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References

  1. American Academy of Otolaryngology – Head and Neck Foundation (1995) Committee on Hearing and Equilibrium guidelines for diagnosis and evaluation of therapy in Menière’s disease. Otolaryngol Head Neck Surg 113:181–185

    Article  Google Scholar 

  2. Balaban CD, Thayer JF (2001) Neurological bases for balance-anxiety links. J Anxiety Disord 15:53–79

    Article  PubMed  CAS  Google Scholar 

  3. Best C, Eckhardt-Henn A, Diener G, et al. (2006) Interaction of somatoform and vestibular disorders. J Neurol Neurosurg Psychiatry 77:658–664

    Article  PubMed  CAS  Google Scholar 

  4. Breslau N, Davis GC, Schultz LR, et al. (1994) Migraine and major depression: a longitudinal study. Headache 34:378–393

    Article  Google Scholar 

  5. Breslau N, Andreski P (1995) Migraine, personality, and psychiatric comorbidity. Headache 35:382–386

    Article  PubMed  CAS  Google Scholar 

  6. Breslau N, Schultz LR, Stewart WF, et al. (2001) Headache types and panic disorder: directionality and specificity. Neurology 56:350–354

    PubMed  CAS  Google Scholar 

  7. Breslau N, Lipton RB, Stewart WF, et al. (2003) Comorbidity of migraine and depression: investigating potential etiology and prognosis. Neurology 60:1308–1312

    PubMed  CAS  Google Scholar 

  8. Cady R, Farmer K, Dexter JK, et al. (2005) Cosensitization of pain and psychiatric comorbidity in chronic daily headache. Curr Pain Headache Rep 9:47–52

    Article  PubMed  Google Scholar 

  9. Celestino D, Rosini E, Carucci ML, et al. (2003) Menière’s disease and anxiety disorders. Acta Otorhinolaryngol Ital 23:421–427

    PubMed  CAS  Google Scholar 

  10. Coker NJ, Coker RR, Jenkins HA, et al. (1989) Psychological profile of patients with Menière’s disease. Arch Otolaryngol Head Neck Surg 115:1355–1357

    PubMed  CAS  Google Scholar 

  11. Eagger S, Luxon LM, Davies RA, et al. (1992) Psychiatric morbidity in patients with peripheral vestibular disorder: a clinical and neuro-otological study. J Neurol Neurosurg Psychiatry 55:383–387

    Article  PubMed  CAS  Google Scholar 

  12. Eckhardt-Henn A, Heuft G, Hochapfel G, Hoffmann SO (eds) (2004) Neurotische Störungen und Psychosomatische Medizin. Stuttgart: Schattauer

  13. Eckhardt-Henn A, Dieterich M (2005) Psychiatric disorders in otoneurology patients. Neurol Clin 23:731–749

    Article  PubMed  Google Scholar 

  14. Furman JM, Balaban CD, Jacob RG, et al. (2005) Migraine-anxiety related dizziness (MARD): a new disorder? Editorial J Neurol Neurosurg Psychiatry 76:1–8

    Article  CAS  Google Scholar 

  15. Godemann F, Koffroth C, Neu P, Heuser I (2004) Why does vertigo become chronic after neuropathia vestibularis? Psychosom Med 66:783–787

    Article  PubMed  Google Scholar 

  16. Hallam RS, Stephens SD (1985) Vestibular disorder and emotional distress. J Psychosom Res 29:407–413

    Article  PubMed  CAS  Google Scholar 

  17. Hermann C, Kaminsky B, Ruger U, et al. (1999) Practicability and clinical relevance of routine psychological screening of patients in general internal medicine units. Psychother Psychosom Med Psychol 49:48–54

    Google Scholar 

  18. Horner KC, Cazals Y (2003) Stress in hearing and balance in Menière’s disease. Noise Health 5:29–34

    PubMed  CAS  Google Scholar 

  19. Jacob RG, Furman JM, Durrant JD, et al. (1996) Panic, agoraphobia, and vestibular dysfunction. Am J Psychiatry 153:503–512

    PubMed  CAS  Google Scholar 

  20. Jacob RG, Furman JM, Joseph M, et al. (1997) Surface dependence: a balance control strategy in panic disorder with agoraphobia. Psychosom Med 59:323–330

    PubMed  CAS  Google Scholar 

  21. Merikangas KR, Merikangas JR, Angst J (1993) Headache syndromes and psychiatric disorders: association and familial transmission. J Psychiatr Res 27:197–210

    Article  PubMed  CAS  Google Scholar 

  22. Merikangas KR, Stevens DE, Angst J (1994) Psychopathology and headache syndromes in the community. Headache 34:17–22

    Article  Google Scholar 

  23. Mitsikostas DD, Thomas AM (1999) Comorbidity of headache and depressive disorders. Cephalgia 19:211–217

    Article  CAS  Google Scholar 

  24. Pappas DG (2003) Autonomic related vertigo. Laryngoscope 113:1658–1671

    Article  PubMed  Google Scholar 

  25. Patel NV, Bigal ME, Kolodner KB, et al. (2004) Prevalence and impact of migraine and probable migraine in a health plan. Neurology 63:1432–1438

    PubMed  CAS  Google Scholar 

  26. Pollak L, Klein C, Rafael S, et al. (2003) Anxiety in the first attack of vertigo. Otolaryngol Head Neck Surg 128:829–834

    Article  PubMed  Google Scholar 

  27. Radtke A, Popov K, Bronstein AM, et al. (2000) Evidence for vestibulo-cardiac reflex in man. Lancet 356:736–737

    Article  PubMed  CAS  Google Scholar 

  28. Rief W, Greitemeyer M, Fichter MM (1991) Kurzberichte über neue diagnostische Verfahren: Die Symptom Check List SCL-90 R: Überprüfung an 900 psychosomatischen Patienten. Diagnostica 25:329–333

    Google Scholar 

  29. Savastano M, Maron MB, Mangialaio M, et al. (1996) Illness behaviour, personality traits, anxiety, and depression in patients with Menière’s disease. J Otolaryngol 25:329–333

    PubMed  CAS  Google Scholar 

  30. Sheftell FD, Atlas SJ (2002) Migraine and psychiatric comorbidity: from theory and hypotheses to clinical application. Headache 42:934–944

    Article  PubMed  Google Scholar 

  31. Silberstein SD, Lipton RB, Breslau N (1995) Migraine: association with personality characteristics and psychopathology. Cephalalgia 15:358–369

    Article  PubMed  CAS  Google Scholar 

  32. Soderman AC, Bagger-Sjoback D, Bergenius J, et al. (2002) Factors influencing quality of life in patients with Menière’s disease, identified by a multidimensional approach. Otol Neurootol 23:941–948

    Article  Google Scholar 

  33. Staab JP, Ruckenstein MJ (2003) Which comes first? Psychogenic dizziness versus otogenic anxiety. The Laryngoscope 113:1714–1718

    Article  PubMed  Google Scholar 

  34. Wacogne C, Lacoste LP, Guillibert E, et al. (2003) Stress, anxiety, depression and migraine. Cephalgia 23:451–455

    Article  CAS  Google Scholar 

  35. Wittchen HU, Burke JD, Semler G, et al. (1989) Recall and dating of psychiatric symptoms. Test retest reliability of time-related symptom questions in a standardized psychiatric interview. Arch Gen Psychiatry 46:473–443

    Google Scholar 

  36. Yardley L, Redfern MS (2001) Psychological factors influencing recovery from balance disorders. J Anxiety Disorders 15:107–119

    Article  CAS  Google Scholar 

  37. Yates BJ, Miller AD (1998) Physiological evidence that the vestibular system participates in autonomic and respiratory control. J Vestib Res 8:17–25

    Article  PubMed  CAS  Google Scholar 

Download references

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Correspondence to A. Eckhardt-Henn.

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Eckhardt-Henn, A., Best, C., Bense, S. et al. Psychiatric comorbidity in different organic vertigo syndromes. J Neurol 255, 420–428 (2008). https://doi.org/10.1007/s00415-008-0697-x

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  • DOI: https://doi.org/10.1007/s00415-008-0697-x

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