title: Cognitive behavior therapy for chronic subjective dizziness: longer-term gains and predictors of disability.
abstract: OBJECTIVE
  The study sought to evaluate the longer-term effects of a brief cognitive behavior therapy (CBT) intervention for patients with chronic subjective dizziness (CSD). In addition, it sought to identify predictors of longer-term disability in this group.
  
  
  METHODS
  Forty-four patients with CSD referred by a neuro-otological clinic were followed-up six months after completing a brief treatment program based on the CBT model of panic disorder. Patients completed the following measures: Dizziness Handicap Inventory, Depression, Anxiety and Stress Scales, Dizziness Symptoms Inventory, and the Safety Behaviours Inventory. Measures were completed at pre and post-treatment, as well as at one and six months post-treatment.
  
  
  RESULTS
  Treatment gains observed immediately after treatment were maintained at one and six months post-treatment. High levels of pre-treatment anxiety predicted higher levels of disability at six months post-treatment. Duration and severity of dizziness, and medical or psychiatric comorbidity did not predict disability at six month follow-up.
  
  
  CONCLUSIONS
  A brief CBT intervention for patients with CSD produced improvements in physical symptoms, disability, and functional impairment which were sustained at one month and six months post intervention. Patients with high levels of anxiety prior to treatment had higher levels of disability at six months post-treatment. It is possible that more focused interventions that specifically target anxiety might produce further benefits for this cohort.
authors.affiliation: Clinical Research Unit for Anxiety and Depression, University of New South Wales at St Vincent's Hospital, Darlinghurst, Sydney, New South Wales, Australia. amahoney@stvincents.com.au
authors.forename: Alison
authors.initials: A
authors.lastname: E J Mahoney
authors.forename: Sarah
authors.initials: S
authors.lastname: Edelman
authors.forename: Phillip
authors.initials: P
authors.lastname: D Cremer
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D004244:Dizziness / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome