title: Psychological factors associated with chronic dizziness in patients aged 60 and older.
abstract: OBJECTIVE
  To identify the prevalence and character of psychological disorders accompanying chronic dizziness in older patients.
  
  
  METHODS
  Case series of patients from a geriatric dizziness clinic, with comparison data from age- and sex-matched healthy community controls. Both cases and controls received screening psychological testing; all cases were evaluated by a clinical psychologist as part of the dizziness clinic evaluation.
  
  
  METHODS
  Multidisciplinary Geriatric Dizziness Clinic.
  
  
  METHODS
  Fifty six consecutive patients with chronic dizziness, evaluated by a multidisciplinary Geriatric Dizziness Clinic, and 68 healthy volunteers whose age and sex distribution matched that of the dizziness clinic patients.
  
  
  METHODS
  Standardized questionnaire for medical, functional, and demographic data; the anxiety, depression, somatization, and phobic anxiety subscales of the Symptom/Checklist-90 (SCL-90-R); the Tinetti gait and motor screen; a physical therapy evaluation; selected laboratory tests; evaluation by a geriatrician; and a formal evaluation by a clinical psychologist, including a semistructured interview. Psychological diagnoses were assigned based on DSM-III-R criteria.
  
  
  RESULTS
  Of these patients with chronic dizziness, 37.5 percent had a psychological diagnosis causing or contributing to their dizziness problem. Of these, only 3 were felt to have a primary psychological cause of their dizziness, and 18 had secondary psychological diagnoses. Anxiety disorders, depression, and adjustment reactions were the most common diagnoses. On multivariate analysis, factors predicting a psychological diagnosis were a positive response to hyperventilation testing, a high score on the SCL-90 anxiety subscale, and fatigue as a precipitant of dizziness. In addition, dizziness clinic patients scored significantly higher (P < 0.001) on all 4 subscales of the SCL-90 when compared with the healthy elderly, suggesting a greater degree of psychological distress among these elderly with chronic dizziness.
  
  
  CONCLUSIONS
  Psychological disorders are rare as primary causes but are common as contributing or modulating factors in older persons with dizziness.
authors.affiliation: Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill 27514-7595.
authors.forename: P D
authors.initials: PD
authors.lastname: Sloane
authors.forename: M
authors.initials: M
authors.lastname: Hartman
authors.forename: C M
authors.initials: CM
authors.lastname: Mitchell
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004244:Dizziness / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales