Psychiatric comorbidity in different organic vertigo syndromes.
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).


CONCLUSIONS
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.
Eckhardt-Henn
Annegret
A
Dept. of Psychosomatic Medicine, Klinikum Stuttgart - Bürgerhospital, Tunzhoferstrasse 14-16, 70191, Stuttgart, Germany. A.Eckhardt@klinikum-stuttgart.de
Best
Christoph
C
Bense
Sandra
S
Breuer
Peter
P
Diener
Gudrun
G
Tschan
Regine
R
Dieterich
Marianne
M
D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications; D015897:Comorbidity; D003866:Depressive Disorder / Q000150:complications; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D013001:Somatoform Disorders / Q000209:etiology; D014717:Vertigo / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D015837:Vestibular Diseases / Q000150:complications