[Phobic orthostatic insecurity].
OBJECTIVE
The authors attempt to expand knowledge about a subjective balance disorder they have called phobic orthostatic insecurity, a condition representing the second cause of medical visits (22.3 %) to their ENT and neuro-otology clinic, and attempt to identify relationships with similar conditions described in psychiatry (agoraphobia, somatoform vertigo, and space-phobia) and in neurology (phobic postural vertigo). They also propose a simple diagnostic method and present their therapies and results.


METHODS
A total of 151 patients with an indefinite symptomatology of "dizziness" "vertigo" or "insecurity" were evaluated (from 1999 to 2005) by means of a full medical history and an appropriate neurological examination, pharmacological treatments with anxiolytics-antidepressives, a measurement of the degree of depression with the Beck test (a kind of psychiatric benchmark) and with a specific standardized test.


RESULTS
Three symptoms and one exploratory condition, among others, were found in all 151 patients studied; these constitute the four bases for a positive diagnosis. This is confirmed if the treatment achieves total remission (this occurred in 69.53 % of all patients) or a sub-total remission (24.49 %), according to valuation scale for insecurity in all situations.


CONCLUSIONS
The statistical analysis showed a symptomatic concordance within the group analyzed, a syndromic equivalence between patients and satisfactory results with the antidepressive treatments (94 %), thus confirming the diagnostic and aetiopathogenic hypotheses for the disorder and, later, providing a logical method for diagnosis. The authors propose to assimilate this diagnostic protocol (and therapeutic when no specialist psychotherapy teams are available) to most of the psychogenic insecurity syndromes described.
Beltrán-Mateos
Luis D
LD
Servicio de Otorrinolaringología, Hospital Virgen de la Concha, Zamora [corrected] España. ldbel@usal.es
Santa Cruz-Ruiz
Santiago
S
Coscarón-Bernabé
Enrique
E
Solana-Sorribas
Juan
J
Gil-Melcón
María
M
Batuecas-Caletrío
Angel
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000379:Agoraphobia / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010698:Phobic Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D014717:Vertigo / Q000175:diagnosis* / Q000209:etiology*