title: Patients' psychological well-being and resilient coping protect from secondary somatoform vertigo and dizziness (SVD) 1 year after vestibular disease.
abstract: Secondary somatoform dizziness and vertigo (SVD) is an underdiagnosed and handicapping psychosomatic disorder, leading to extensive utilization of health care and maladaptive coping. Few long-term follow-up studies have focused on the assessment of risk factors and little is known about protective factors. The aim of this 1-year follow-up study was to identify neurootological patients at risk for the development of secondary SVD with respect to individual psychopathological disposition, subjective well-being and resilient coping. In a prospective interdisciplinary study, we assessed mental disorders in n=59 patients with peripheral and central vestibular disorders (n=15 benign paroxysmal positional vertigo, n=15 vestibular neuritis, n=8 Menière's disease, n=24 vestibular migraine) at baseline (T0) and 1 year after admission (T1). Psychosomatic examinations included the structured clinical interview for DSM-IV, the Vertigo Symptom Scale (VSS), and a psychometric test battery measuring resilience (RS), sense of coherence (SOC), and satisfaction with life (SWLS). Subjective well-being significantly predicted the development of secondary SVD: Patients with higher scores of RS, SOC, and SWLS at T0 were less likely to acquire secondary SVD at T1. Lifetime mental disorders correlated with a reduced subjective well-being at T0. Patients with mental comorbidity at T0 were generally more at risk for developing secondary SVD at T1. Patients' dispositional psychopathology and subjective well-being play a major predictive role for the long-term prognosis of dizziness and vertigo. To prevent secondary SVD, patients should be screened for risk and preventive factors, and offered psychotherapeutic treatment in case of insufficient coping capacity.
authors: Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany. tschan@psychosomatik.klinik.uni-mainz.de
authors: Regine
authors: R
authors: Tschan
authors: Christoph
authors: C
authors: Best
authors: Manfred E
authors: ME
authors: Beutel
authors: Achim
authors: A
authors: Knebel
authors: Jörg
authors: J
authors: Wiltink
authors: Marianne
authors: M
authors: Dieterich
authors: Annegret
authors: A
authors: Eckhardt-Henn
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004244:Dizziness / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000150:complications; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D008875:Middle Aged; D009460:Neurologic Examination; D010549:Personal Satisfaction; D011594:Psychometrics; D011788:Quality of Life; D055500:Resilience, Psychological; D012307:Risk Factors; D014717:Vertigo / Q000209:etiology / Q000523:psychology*; D015837:Vestibular Diseases / Q000150:complications / Q000523:psychology*; D020338:Vestibular Neuronitis / Q000150:complications