title: Dizziness: anxiety, health care utilization and health behavior--results from a representative German community survey.
abstract: BACKGROUND
  Due to the lack of epidemiological data on the relation of dizziness and anxiety, we investigated the prevalence of dizziness and anxiety in a representative sample of the German population. We explored the consequences of comorbid anxiety for emotional distress, functional impairment, health care utilization, and health behavior in dizziness.
  
  
  METHODS
  By the end of 2006, we surveyed a total of 1287 persons between 14 and 90 years of age in their homes by trained interviewers with standardized self-rating questionnaires on anxiety (Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Mini-Social Phobia Inventory) and dizziness (Vertigo Symptom Scale). The sample was representative for the German population in terms of age, sex, and education.
  
  
  RESULTS
  Symptoms of dizziness were reported by 15.8% of the participants. Of the participants with dizziness, 28.3% reported symptoms of at least one anxiety disorder (generalized anxiety, social phobia, panic). Persons with dizziness reported more somatic problems such as hypertension, migraine, diabetes, etc. Comorbid anxiety was associated with increased health care use and impairment.
  
  
  CONCLUSIONS
  Dizziness is a highly prevalent symptom in the general population. A subgroup with comorbid anxiety is characterized by an increased subjective impairment and health care utilization due to their dizziness. Because treatment options for distinct neurotologic disorders are also known to reduce psychological symptoms, and in order to avoid unnecessary medical treatment, early neurologic and psychiatric/psychotherapeutic referral may be indicated.
authors.affiliation: Clinic of Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg-University Mainz, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Wiltink
authors.forename: Regine
authors.initials: R
authors.lastname: Tschan
authors.forename: Matthias
authors.initials: M
authors.lastname: Michal
authors.forename: Claudia
authors.initials: C
authors.lastname: Subic-Wrana
authors.forename: Annegret
authors.initials: A
authors.lastname: Eckhardt-Henn
authors.forename: Marianne
authors.initials: M
authors.lastname: Dieterich
authors.forename: Manfred E
authors.initials: ME
authors.lastname: Beutel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003625:Data Collection / Q000379:methods; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000453:epidemiology; D004244:Dizziness / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005858:Germany; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology; D016584:Panic Disorder / Q000453:epidemiology; D010698:Phobic Disorders / Q000453:epidemiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D055815:Young Adult