Research Article
Baş Dönmesi Şikayeti Olan Yetişkinlerin Psikolojik Karşılaştırması: Tipik ve Anormal Vestibüler Test Sonuçlarında Depresyon, Anksiyete ve Somatizasyon
Abstract
Amaç: Bu çalışma, baş dönmesi şikayeti olan bireylerde vestibüler test sonuçları ile depresyon, anksiyete ve somatizasyon düzeyleri arasındaki ilişkiyi incelemeyi amaçlamaktadır. Ayrıca, vestibülo-oküler refleks (VOR) test bulguları ile subjektif değerlendirme ölçekleri arasındaki korelasyon değerlendirilmiştir.
Gereç ve Yöntemler: Baş dönmesi şikayeti olan 60 hasta iki gruba ayrıldı: Grup I (n=30, vestibüler testlerde anormal bulgu saptananlar) ve Grup II (n=30, vestibüler testleri normal olanlar). Tüm katılımcılara odyolojik ve vestibüler değerlendirmeler [videonistagmografi (VNG), video baş impuls testi (vHIT)] ile birlikte psikolojik ölçekler [Beck Depresyon Envanteri (BDI), Beck Anksiyete Envanteri (BAI), Belirti Tarama Listesi-90 (SCL-90) Somatizasyon alt ölçeği] uygulandı. Veriler SPSS 22.0 programı kullanılarak analiz edildi ve istatistiksel anlamlılık düzeyi p<0.05 olarak kabul edildi.
Bulgular: BDI, BAI ve somatizasyon puanları açısından gruplar arasında anlamlı fark gözlenmedi (p>0.05). Ancak Grup I’te Dizziness Handicap Inventory (DHI) toplam ve duygusal alt ölçek puanları anlamlı şekilde daha yüksek bulundu (p<0.05). Ayrıca bu grupta DHI ile BDI ve BAI arasında pozitif korelasyon saptandı (p<0.05). Her iki grupta da vHIT sonuçları ile psikolojik değerlendirme ölçekleri arasında anlamlı bir ilişki bulunmadı.
Sonuç: Vestibüler test sonuçları, depresyon, anksiyete ve somatizasyon düzeylerini doğrudan etkilememektedir. Bununla birlikte, DHI gibi subjektif ölçekler baş dönmesinin psikolojik etkilerini yansıtabilir ve bu ölçümler, klinik yönlendirme süreçlerinde yardımcı bir araç olarak değerlendirilebilir.
Project Number
(Tarih: 17 Ocak 2018; Karar Numarası: 11)
References
- 1. Neuhauser HK. Epidemiology of vertigo. Current opinion in neurology. 2007;20(1):40-6.
- 2. Cullen KE. The vestibular system: multimodal integration and encoding of self-motion for motor control. Trends Neurosci. 2012;35(3):185-96.
- 3. Borel L, Lopez C, Péruch P, Lacour M. Vestibular syndrome: a change in internal spatial representation. Neurophysiologie Clinique/Clinical Neurophysiology. 2008;38(6):375-89.
- 4. Best C, Tschan R, Eckhardt-Henn A, Dieterich M. Who is at risk for ongoing dizziness and psychological strain after a vestibular disorder? Neuroscience. 2009;164(4):1579-87.
- 5. Gurgel LG, Dourado MR, Moreira TdC, Serafini AJ, Menegotto IH, Reppold CT, et al. Correlation between vestibular test results and self-reported psychological complaints of patients with vestibular symptoms. Brazilian Journal of otorhinolaryngology. 2012;78:62-7.
- 6. Strupp M, Brandt T. Diagnosis and treatment of vertigo and dizziness. Dtsch Arztebl Int. 2008;105(10):173-80.
- 7. Patel M, Arshad Q, Roberts RE, Ahmad H, Bronstein AM. Chronic symptoms after vestibular neuritis and the high-velocity vestibulo-ocular reflex. Otology & Neurotology. 2016;37(2):179-84.
- 8. Yip CW, Strupp M. The Dizziness Handicap Inventory does not correlate with vestibular function tests: a prospective study. Journal of neurology. 2018;265:1210-8.
- 9. Phillips JS, FitzGerald JE, Bath AP. The role of the vestibular assessment. J Laryngol Otol. 2009;123(11):1212-5.
- 10. Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician. 2010;82(4):361-8, 9.
- 11. Tirelli G, Rigo S, Bullo F, Meneguzzi C, Gregori D, Gatto A. Saccades and smooth pursuit eye movements in central vertigo. ACTA otorhinolaryngologica italica. 2011;31(2):96.
- 12. Newman-Toker DE, Hsieh Y-H, Camargo Jr CA, Pelletier AJ, Butchy GT, Edlow JA, editors. Spectrum of dizziness visits to US emergency departments: cross-sectional analysis from a nationally representative sample. Mayo Clinic Proceedings; 2008: Elsevier.
- 13. Nishikawa D, Wada Y, Shiozaki T, Shugyo M, Ito T, Ota I, et al. Patients with vertigo/dizziness of unknown origin during follow-ups by general otolaryngologists at outpatient town clinic. Auris Nasus Larynx. 2021;48(3):400-7.
- 14. Hoffman RM, Einstadter D, Kroenke K. Evaluating dizziness. Am J Med. 1999;107(5):468-78.
- 15. Eckhardt-Henn A, Best C, Bense S, Breuer P, Diener G, Tschan R, et al. Psychiatric comorbidity in different organic vertigo syndromes. J Neurol. 2008;255(3):420-8.
- 16. Yardley L, Beech S, Weinman J. Influence of beliefs about the consequences of dizziness on handicap in people with dizziness, and the effect of therapy on beliefs. Journal of psychosomatic research. 2001;50(1):1-6.
- 17. Gofrit SG, Mayler Y, Eliashar R, Bdolah-Abram T, Ilan O, Gross M. The association between vestibular physical examination, vertigo questionnaires, and the electronystagmography in patients with vestibular symptoms: a prospective study. Annals of Otology, Rhinology & Laryngology. 2017;126(4):315-21.
- 18. Herdman D, Norton S, Pavlou M, Murdin L, Moss-Morris R. Vestibular deficits and psychological factors correlating to dizziness handicap and symptom severity. Journal of psychosomatic research. 2020;132:109969.
- 19. Kirbac A, Kaya E, Incesulu SA, Carman KB, Yarar C, Ozen H, et al. Differentiation of peripheral and non-peripheral etiologies in children with vertigo/dizziness: The video-head impulse test and suppression head impulse paradigm. International Journal of Pediatric Otorhinolaryngology. 2024;179:111935.
- 20. Vorobyev A, Farrelly S, Hartis A, Monsch E, Strange C, Rizk H, et al. Optimizing Stroke Assessment of Dizziness: The Role and Impact of Video Head Impulse Testing. Stroke: Vascular and Interventional Neurology. 2024;4:e12984_350.
- 21. Luchikhin L, Kunel'skaya N, Guseva A, Dovlatova E, Chistov S. The diagnostic significance of the clinical methods for the investigation into the oculomotor reactions to dizziness. Vestnik otorinolaringologii. 2015;80(2):8-11.
- 22. Rutenkröger M, Scheer M, Rampp S, Strauss C, Schönfeld R, Leplow B. Associations between Psychological Factors and Long-Term Dizziness Handicap in Vestibular Schwannoma Patients: A Cross-Sectional Study. medRxiv. 2024:2024.10. 19.24315803.
- 23. Jacobson GP, Piker EG, Hatton K, Watford KE, Trone T, McCaslin DL, et al. Development and preliminary findings of the dizziness symptom profile. Ear and hearing. 2019;40(3):568-76.
- 24. Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society. Journal of Vestibular Research. 2017;27(4):191-208.
- 25. Garrison D, Barth L, Kaylie D, Riska K. Symptoms, audiometric and vestibular laboratory findings, and imaging in a concurrent superior canal dehiscence syndrome and vestibular schwannoma: a case report. Journal of the American Academy of Audiology. 2020;31(01):076-82.
- 26. Behrbohm H, Kaschke O. Ear, nose, and throat diseases: with head and neck surgery: Thieme; 2009.
- 27. Kerber KA, Baloh RW. The evaluation of a patient with dizziness. Neurol Clin Pract. 2011;1(1):24-33.
- 28. Wu C-N, Luo S-D, Chen S-F, Huang C-W, Chiang P-L, Hwang C-F, et al. Applicability of Oculomotor Tests for Predicting Central Vestibular Disorder Using Principal Component Analysis. Journal of Personalized Medicine. 2022;12(2):203.
- 29. Mossman B, Mossman S, Purdie G, Schneider E. Age dependent normal horizontal VOR gain of head impulse test as measured with video-oculography. Journal of Otolaryngology-Head & Neck Surgery. 2015;44:1-8.
- 30. Vereeck L, Truijen S, Wuyts FL, Van de Heyning PH. The dizziness handicap inventory and its relationship with functional balance performance. Otology & neurotology. 2007;28(1):87-93.
- 31. Karapolat H, Eyigor S, Kirazlı Y, Celebisoy N, Bilgen C, Kirazli T. Reliability, Validity and Sensitivity to Change of Turkish Dizziness Handicap Inventory (DHI) in Patients with Unilateral Peripheral Vestibular Disease. Journal of International Advanced Otology. 2009;5(2).
- 32. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of general psychiatry. 1961;4(6):561-71.
- 33. Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. Journal of cognitive psychotherapy. 1998;12(2):163.
- 34. Holi M. Assessment of psychiatric symptoms using the SCL-90: Helsingin yliopisto; 2003.
- 35. Best C, Eckhardt-Henn A, Diener G, Bense S, Breuer P, Dieterich M. Interaction of somatoform and vestibular disorders. Journal of Neurology, Neurosurgery & Psychiatry. 2006;77(5):658-64.
- 36. 井上亜希, 西村信一, 藤本千里, 岩﨑真一. めまい疾患における日常生活障害度に関連する心理学的特性について. Equilibrium Research. 2023;82(2):98-104.
- 37. Kim TS, Lee WH, Heo Y. Prevalence and contributing factors of anxiety and depression in patients with vestibular migraine. Ear, Nose & Throat Journal. 2024;103(5):305-12.
- 38. Omara A, Basiouny EM, Shabrawy ME, Shafei RRE. The correlation between anxiety, depression, and vertigo: a cross-sectional study. The Egyptian Journal of Otolaryngology. 2022;38(1):143.
- 39. Subasi B, Yildirim N, Akbey ZY, Karaman NE, Arik O. Correlations of Clinical and Audio-Vestibulometric Findings with Coexisting Anxiety and Depression in Meniere's Disease Patients. Audiol Neurootol. 2023;28(2):75-83.
- 40. Zamyslowska-Szmytke E, Politanski P, Jozefowicz-Korczynska M. Dizziness handicap inventory in clinical evaluation of dizzy patients. International Journal of Environmental Research and Public Health. 2021;18(5):2210.
- 41. Piker EG, Jacobson GP, McCaslin DL, Grantham SL. Psychological comorbidities and their relationship to self-reported handicap in samples of dizzy patients. Journal of the American Academy of Audiology. 2008;19(04):337-47.
- 42. Schmid D, Allum J, Sleptsova M, Welge-Lüssen A, Schaefert R, Meinlschmidt G, et al. Relation of anxiety and other psychometric measures, balance deficits, impaired quality of life, and perceived state of health to dizziness handicap inventory scores for patients with dizziness. Health and quality of life outcomes. 2020;18:1-15.
- 43. Saman Y, McLellan L, McKenna L, Dutia MB, Obholzer R, Libby G, et al. State Anxiety Subjective Imbalance and Handicap in Vestibular Schwannoma. Front Neurol. 2016;7:101.
- 44. Swamy SN, Yuvaraj P, Pruthi N, Thennarasu K, Rajasekaran AK. Comprehensive normative data for objective vestibular tests. Cureus. 2023;15(6).
Psychological Comparison of Adults with Dizziness: Depression, Anxiety, and Somatization in Typical vs. Abnormal Vestibular Test Results
Abstract
Introduction: The association between vestibular deficits and psychological symptoms remains controversial. Thus, this paper aims to report the psychological state of patients complaining of dizziness according to whether their symptoms are observed or not. Methods: Sixty patients with dizziness symptoms were included in the study. Videonystagmography, video head impulse test, and vestibulospinal tests were applied to all patients. 30 dizzy patients with positive findings were included in Group I, and 30 dizzy patients with typical results from all tests were included in Group II. All individuals were asked to fill out the Beck Depression Inventory, Beck Anxiety Inventory, Dizziness Handicap Inventory, and Somatization subscale of the Symptom Checklist, and the findings were compared between the two groups. The relationship between BDI, BAI, and SOM results and vHIT and DHI scores in all individuals was examined. Results: There was no significant difference between the two groups regarding depression, anxiety, and somatization. The level of disability due to dizziness was significantly higher in group II compared to group I. A significant correlation was found between DHI scores and depression and anxiety scores in all patients. Similar psychogenic effects were observed between the groups. However, individuals with dizziness who had regular vestibular tests had a higher level of disability due to dizziness. Conclusion: Evaluation of psychogenic affect and disability due to dizziness by questionnaires in dizzy individuals with regular vestibular tests can be a guide in performing advanced vestibular examinations or directing the patient to a comprehensive psychological evaluation.
Ethical Statement
This study was conducted in accordance with the ethical standards outlined in the Declaration of Helsinki and approved by the Ankara Yildirim Beyazit Universit Clinical Research Ethical Committiee on January 17, 2018 (Decision Number: 11). All participants provided written informed consent prior to their inclusion in the study. The authors confirm that all necessary measures were taken to ensure the confidentiality and anonymity of participant data throughout the research process. Additionally, there were no conflicts of interest or financial relationships that could influence the results of this study.
Supporting Institution
Yok
Project Number
(Tarih: 17 Ocak 2018; Karar Numarası: 11)
References
- 1. Neuhauser HK. Epidemiology of vertigo. Current opinion in neurology. 2007;20(1):40-6.
- 2. Cullen KE. The vestibular system: multimodal integration and encoding of self-motion for motor control. Trends Neurosci. 2012;35(3):185-96.
- 3. Borel L, Lopez C, Péruch P, Lacour M. Vestibular syndrome: a change in internal spatial representation. Neurophysiologie Clinique/Clinical Neurophysiology. 2008;38(6):375-89.
- 4. Best C, Tschan R, Eckhardt-Henn A, Dieterich M. Who is at risk for ongoing dizziness and psychological strain after a vestibular disorder? Neuroscience. 2009;164(4):1579-87.
- 5. Gurgel LG, Dourado MR, Moreira TdC, Serafini AJ, Menegotto IH, Reppold CT, et al. Correlation between vestibular test results and self-reported psychological complaints of patients with vestibular symptoms. Brazilian Journal of otorhinolaryngology. 2012;78:62-7.
- 6. Strupp M, Brandt T. Diagnosis and treatment of vertigo and dizziness. Dtsch Arztebl Int. 2008;105(10):173-80.
- 7. Patel M, Arshad Q, Roberts RE, Ahmad H, Bronstein AM. Chronic symptoms after vestibular neuritis and the high-velocity vestibulo-ocular reflex. Otology & Neurotology. 2016;37(2):179-84.
- 8. Yip CW, Strupp M. The Dizziness Handicap Inventory does not correlate with vestibular function tests: a prospective study. Journal of neurology. 2018;265:1210-8.
- 9. Phillips JS, FitzGerald JE, Bath AP. The role of the vestibular assessment. J Laryngol Otol. 2009;123(11):1212-5.
- 10. Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician. 2010;82(4):361-8, 9.
- 11. Tirelli G, Rigo S, Bullo F, Meneguzzi C, Gregori D, Gatto A. Saccades and smooth pursuit eye movements in central vertigo. ACTA otorhinolaryngologica italica. 2011;31(2):96.
- 12. Newman-Toker DE, Hsieh Y-H, Camargo Jr CA, Pelletier AJ, Butchy GT, Edlow JA, editors. Spectrum of dizziness visits to US emergency departments: cross-sectional analysis from a nationally representative sample. Mayo Clinic Proceedings; 2008: Elsevier.
- 13. Nishikawa D, Wada Y, Shiozaki T, Shugyo M, Ito T, Ota I, et al. Patients with vertigo/dizziness of unknown origin during follow-ups by general otolaryngologists at outpatient town clinic. Auris Nasus Larynx. 2021;48(3):400-7.
- 14. Hoffman RM, Einstadter D, Kroenke K. Evaluating dizziness. Am J Med. 1999;107(5):468-78.
- 15. Eckhardt-Henn A, Best C, Bense S, Breuer P, Diener G, Tschan R, et al. Psychiatric comorbidity in different organic vertigo syndromes. J Neurol. 2008;255(3):420-8.
- 16. Yardley L, Beech S, Weinman J. Influence of beliefs about the consequences of dizziness on handicap in people with dizziness, and the effect of therapy on beliefs. Journal of psychosomatic research. 2001;50(1):1-6.
- 17. Gofrit SG, Mayler Y, Eliashar R, Bdolah-Abram T, Ilan O, Gross M. The association between vestibular physical examination, vertigo questionnaires, and the electronystagmography in patients with vestibular symptoms: a prospective study. Annals of Otology, Rhinology & Laryngology. 2017;126(4):315-21.
- 18. Herdman D, Norton S, Pavlou M, Murdin L, Moss-Morris R. Vestibular deficits and psychological factors correlating to dizziness handicap and symptom severity. Journal of psychosomatic research. 2020;132:109969.
- 19. Kirbac A, Kaya E, Incesulu SA, Carman KB, Yarar C, Ozen H, et al. Differentiation of peripheral and non-peripheral etiologies in children with vertigo/dizziness: The video-head impulse test and suppression head impulse paradigm. International Journal of Pediatric Otorhinolaryngology. 2024;179:111935.
- 20. Vorobyev A, Farrelly S, Hartis A, Monsch E, Strange C, Rizk H, et al. Optimizing Stroke Assessment of Dizziness: The Role and Impact of Video Head Impulse Testing. Stroke: Vascular and Interventional Neurology. 2024;4:e12984_350.
- 21. Luchikhin L, Kunel'skaya N, Guseva A, Dovlatova E, Chistov S. The diagnostic significance of the clinical methods for the investigation into the oculomotor reactions to dizziness. Vestnik otorinolaringologii. 2015;80(2):8-11.
- 22. Rutenkröger M, Scheer M, Rampp S, Strauss C, Schönfeld R, Leplow B. Associations between Psychological Factors and Long-Term Dizziness Handicap in Vestibular Schwannoma Patients: A Cross-Sectional Study. medRxiv. 2024:2024.10. 19.24315803.
- 23. Jacobson GP, Piker EG, Hatton K, Watford KE, Trone T, McCaslin DL, et al. Development and preliminary findings of the dizziness symptom profile. Ear and hearing. 2019;40(3):568-76.
- 24. Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society. Journal of Vestibular Research. 2017;27(4):191-208.
- 25. Garrison D, Barth L, Kaylie D, Riska K. Symptoms, audiometric and vestibular laboratory findings, and imaging in a concurrent superior canal dehiscence syndrome and vestibular schwannoma: a case report. Journal of the American Academy of Audiology. 2020;31(01):076-82.
- 26. Behrbohm H, Kaschke O. Ear, nose, and throat diseases: with head and neck surgery: Thieme; 2009.
- 27. Kerber KA, Baloh RW. The evaluation of a patient with dizziness. Neurol Clin Pract. 2011;1(1):24-33.
- 28. Wu C-N, Luo S-D, Chen S-F, Huang C-W, Chiang P-L, Hwang C-F, et al. Applicability of Oculomotor Tests for Predicting Central Vestibular Disorder Using Principal Component Analysis. Journal of Personalized Medicine. 2022;12(2):203.
- 29. Mossman B, Mossman S, Purdie G, Schneider E. Age dependent normal horizontal VOR gain of head impulse test as measured with video-oculography. Journal of Otolaryngology-Head & Neck Surgery. 2015;44:1-8.
- 30. Vereeck L, Truijen S, Wuyts FL, Van de Heyning PH. The dizziness handicap inventory and its relationship with functional balance performance. Otology & neurotology. 2007;28(1):87-93.
- 31. Karapolat H, Eyigor S, Kirazlı Y, Celebisoy N, Bilgen C, Kirazli T. Reliability, Validity and Sensitivity to Change of Turkish Dizziness Handicap Inventory (DHI) in Patients with Unilateral Peripheral Vestibular Disease. Journal of International Advanced Otology. 2009;5(2).
- 32. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of general psychiatry. 1961;4(6):561-71.
- 33. Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. Journal of cognitive psychotherapy. 1998;12(2):163.
- 34. Holi M. Assessment of psychiatric symptoms using the SCL-90: Helsingin yliopisto; 2003.
- 35. Best C, Eckhardt-Henn A, Diener G, Bense S, Breuer P, Dieterich M. Interaction of somatoform and vestibular disorders. Journal of Neurology, Neurosurgery & Psychiatry. 2006;77(5):658-64.
- 36. 井上亜希, 西村信一, 藤本千里, 岩﨑真一. めまい疾患における日常生活障害度に関連する心理学的特性について. Equilibrium Research. 2023;82(2):98-104.
- 37. Kim TS, Lee WH, Heo Y. Prevalence and contributing factors of anxiety and depression in patients with vestibular migraine. Ear, Nose & Throat Journal. 2024;103(5):305-12.
- 38. Omara A, Basiouny EM, Shabrawy ME, Shafei RRE. The correlation between anxiety, depression, and vertigo: a cross-sectional study. The Egyptian Journal of Otolaryngology. 2022;38(1):143.
- 39. Subasi B, Yildirim N, Akbey ZY, Karaman NE, Arik O. Correlations of Clinical and Audio-Vestibulometric Findings with Coexisting Anxiety and Depression in Meniere's Disease Patients. Audiol Neurootol. 2023;28(2):75-83.
- 40. Zamyslowska-Szmytke E, Politanski P, Jozefowicz-Korczynska M. Dizziness handicap inventory in clinical evaluation of dizzy patients. International Journal of Environmental Research and Public Health. 2021;18(5):2210.
- 41. Piker EG, Jacobson GP, McCaslin DL, Grantham SL. Psychological comorbidities and their relationship to self-reported handicap in samples of dizzy patients. Journal of the American Academy of Audiology. 2008;19(04):337-47.
- 42. Schmid D, Allum J, Sleptsova M, Welge-Lüssen A, Schaefert R, Meinlschmidt G, et al. Relation of anxiety and other psychometric measures, balance deficits, impaired quality of life, and perceived state of health to dizziness handicap inventory scores for patients with dizziness. Health and quality of life outcomes. 2020;18:1-15.
- 43. Saman Y, McLellan L, McKenna L, Dutia MB, Obholzer R, Libby G, et al. State Anxiety Subjective Imbalance and Handicap in Vestibular Schwannoma. Front Neurol. 2016;7:101.
- 44. Swamy SN, Yuvaraj P, Pruthi N, Thennarasu K, Rajasekaran AK. Comprehensive normative data for objective vestibular tests. Cureus. 2023;15(6).
There are 44 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Otorhinolaryngology, Psychiatry, Sensory Systems, Health Care Administration |
| Journal Section | Research Article |
| Authors | |
| Project Number | (Tarih: 17 Ocak 2018; Karar Numarası: 11) |
| Early Pub Date | June 22, 2025 |
| Publication Date | June 23, 2025 |
| Submission Date | December 29, 2024 |
| Acceptance Date | June 10, 2025 |
| Published in Issue | Year 2025 Volume: 26 Issue: 2 |
