Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1998 Nov;65(5):679–684. doi: 10.1136/jnnp.65.5.679

Neuro-otological and psychiatric abnormalities in a community sample of people with dizziness: a blind, controlled investigation

L Yardley 1, J Burgneay 1, I Nazareth 1, L Luxon 1
PMCID: PMC2170353  PMID: 9810937

Abstract

OBJECTIVES—To determine neuro-otological and psychiatric abnormalities associated with complaints of dizziness in an epidemiological community sample of people of working age, and the extent of comorbidity between neuro-otological and psychiatric dysfunction.
METHOD—A survey of 3884 people randomly selected from six general practice lists identified 262 people with significant dizziness, from which a subsample of 15 men and 22 women were recruited for testing. Dizzy subjects were evaluated by blind neuro-otological testing, computerised dynamic posturography, a computerised psychiatric assessment, neuro-otological and general medical examination, and diagnosis. An age matched control group of 18 men and 22 women underwent the same evaluation.
RESULTS—Tests of auditory, vestibular, and oculo-motor function did not discriminate between dizzy subjects and controls, but dizzy subjects had significantly worse balance on posturographic testing, more diagnoses of medical disorder, and a higher prevalence of psychiatric morbidity.
CONCLUSIONS—The findings suggest that dizziness in the community is typically characterised by mild physical disorder accompanied by some psychiatric disturbance. As the combination of minor physical and psychiatric disorder is known to be unusually persistent and handicapping, treatment programmes must be provided for this prevalent syndrome, perhaps by a partnership between primary care and neuro-otological and psychiatric hospital outpatient clinics with experience and expertise in the diagnosis and management of dizziness and psychiatric disturbance.



Full Text

The Full Text of this article is available as a PDF (113.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brandt T. Phobic postural vertigo. Neurology. 1996 Jun;46(6):1515–1519. doi: 10.1212/wnl.46.6.1515. [DOI] [PubMed] [Google Scholar]
  2. Clark D. B., Hirsch B. E., Smith M. G., Furman J. M., Jacob R. G. Panic in otolaryngology patients presenting with dizziness or hearing loss. Am J Psychiatry. 1994 Aug;151(8):1223–1225. doi: 10.1176/ajp.151.8.1223. [DOI] [PubMed] [Google Scholar]
  3. Clark M. R., Sullivan M. D., Fischl M., Katon W. J., Russo J. E., Dobie R. A., Voorhees R. Symptoms as a clue to otologic and psychiatric diagnosis in patients with dizziness. J Psychosom Res. 1994 Jul;38(5):461–470. doi: 10.1016/0022-3999(94)90107-4. [DOI] [PubMed] [Google Scholar]
  4. Drachman D. A., Hart C. W. An approach to the dizzy patient. Neurology. 1972 Apr;22(4):323–334. doi: 10.1212/wnl.22.4.323. [DOI] [PubMed] [Google Scholar]
  5. Eagger S., Luxon L. M., Davies R. A., Coelho A., Ron M. A. Psychiatric morbidity in patients with peripheral vestibular disorder: a clinical and neuro-otological study. J Neurol Neurosurg Psychiatry. 1992 May;55(5):383–387. doi: 10.1136/jnnp.55.5.383. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Frommberger U. H., Tettenborn B., Buller R., Benkert O. Panic disorder in patients with dizziness. Arch Intern Med. 1994 Mar 14;154(5):590–591. doi: 10.1001/archinte.154.5.590a. [DOI] [PubMed] [Google Scholar]
  7. Furman J. M., Jacob R. G. Psychiatric dizziness. Neurology. 1997 May;48(5):1161–1166. doi: 10.1212/wnl.48.5.1161. [DOI] [PubMed] [Google Scholar]
  8. Grimby A., Rosenhall U. Health-related quality of life and dizziness in old age. Gerontology. 1995;41(5):286–298. doi: 10.1159/000213696. [DOI] [PubMed] [Google Scholar]
  9. Jacob R. G., Furman J. M., Durrant J. D., Turner S. M. Panic, agoraphobia, and vestibular dysfunction. Am J Psychiatry. 1996 Apr;153(4):503–512. doi: 10.1176/ajp.153.4.503. [DOI] [PubMed] [Google Scholar]
  10. Jacob R. G. Panic disorder and the vestibular system. Psychiatr Clin North Am. 1988 Jun;11(2):361–374. [PubMed] [Google Scholar]
  11. Kroenke K., Lucas C. A., Rosenberg M. L., Scherokman B. J. Psychiatric disorders and functional impairment in patients with persistent dizziness. J Gen Intern Med. 1993 Oct;8(10):530–535. doi: 10.1007/BF02599633. [DOI] [PubMed] [Google Scholar]
  12. Kroenke K., Lucas C. A., Rosenberg M. L., Scherokman B., Herbers J. E., Jr, Wehrle P. A., Boggi J. O. Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. Ann Intern Med. 1992 Dec 1;117(11):898–904. doi: 10.7326/0003-4819-117-11-898. [DOI] [PubMed] [Google Scholar]
  13. Lajoie Y., Teasdale N., Bard C., Fleury M. Attentional demands for static and dynamic equilibrium. Exp Brain Res. 1993;97(1):139–144. doi: 10.1007/BF00228824. [DOI] [PubMed] [Google Scholar]
  14. Lewis G. Assessing psychiatric disorder with a human interviewer or a computer. J Epidemiol Community Health. 1994 Apr;48(2):207–210. doi: 10.1136/jech.48.2.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Lewis G., Pelosi A. J., Glover E., Wilkinson G., Stansfeld S. A., Williams P., Shepherd M. The development of a computerized assessment for minor psychiatric disorder. Psychol Med. 1988 Aug;18(3):737–745. doi: 10.1017/s0033291700008448. [DOI] [PubMed] [Google Scholar]
  16. Sklare D. A., Stein M. B., Pikus A. M., Uhde T. W. Dysequilibrium and audiovestibular function in panic disorder: symptom profiles and test findings. Am J Otol. 1990 Sep;11(5):338–341. [PubMed] [Google Scholar]
  17. Sloane P. D., Dallara J., Roach C., Bailey K. E., Mitchell M., McNutt R. Management of dizziness in primary care. J Am Board Fam Pract. 1994 Jan-Feb;7(1):1–8. [PubMed] [Google Scholar]
  18. Sloane P. D. Dizziness in primary care. Results from the National Ambulatory Medical Care Survey. J Fam Pract. 1989 Jul;29(1):33–38. [PubMed] [Google Scholar]
  19. Sloane P., Blazer D., George L. K. Dizziness in a community elderly population. J Am Geriatr Soc. 1989 Feb;37(2):101–108. doi: 10.1111/j.1532-5415.1989.tb05867.x. [DOI] [PubMed] [Google Scholar]
  20. Sullivan M., Clark M. R., Katon W. J., Fischl M., Russo J., Dobie R. A., Voorhees R. Psychiatric and otologic diagnoses in patients complaining of dizziness. Arch Intern Med. 1993 Jun 28;153(12):1479–1484. [PubMed] [Google Scholar]
  21. Weindruch R., Korper S. P., Hadley E. The prevalence of dysequilibrium and related disorders in older persons. Ear Nose Throat J. 1989 Dec;68(12):925–929. [PubMed] [Google Scholar]
  22. Yardley L., Beech S., Zander L., Evans T., Weinman J. A randomized controlled trial of exercise therapy for dizziness and vertigo in primary care. Br J Gen Pract. 1998 Apr;48(429):1136–1140. [PMC free article] [PubMed] [Google Scholar]
  23. Yardley L., Britton J., Lear S., Bird J., Luxon L. M. Relationship between balance system function and agoraphobic avoidance. Behav Res Ther. 1995 May;33(4):435–439. doi: 10.1016/0005-7967(94)00060-w. [DOI] [PubMed] [Google Scholar]
  24. Yardley L., Luxon L. M., Haacke N. P. A longitudinal study of symptoms, anxiety and subjective well-being in patients with vertigo. Clin Otolaryngol Allied Sci. 1994 Apr;19(2):109–116. doi: 10.1111/j.1365-2273.1994.tb01192.x. [DOI] [PubMed] [Google Scholar]
  25. Yardley L., Owen N., Nazareth I., Luxon L. Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract. 1998 Apr;48(429):1131–1135. [PMC free article] [PubMed] [Google Scholar]
  26. Yates B. J., Sklare D. A., Frey M. A. Vestibular autonomic regulation: overview and conclusions of a recent workshop at the University of Pittsburgh. J Vestib Res. 1998 Jan-Feb;8(1):1–5. [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES