title: Persistence of symptoms in primary somatoform vertigo and dizziness: a disorder "lost" in health care?
abstract: The aim of this study was to perform a 3-year follow-up of primary somatoform vertigo and dizziness (SVD) regarding health care use and treatment. Ninety-two patients with dizziness underwent detailed vestibular neurophysiological testing and a Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Psychometric assessments comprised the Vertigo Symptom Scale, the Vertigo Handicap Questionnaire, the SCL-90-R, and the Short-Form-36 Health Survey. At the 3-year follow-up, 65 patients with primary SVD (anxiety, n = 29; depression, n = 14; somatoform disorders, n = 22) were reassessed (70.7% response). The patients improved in symptom severity (p < 0.05), handicap (p < 0.01), and physical quality of life (QoL; p < 0.05) but showed no change in emotional distress. A total of 63.1% (of n = 65) had ongoing SVD. A total of 69.2% (of n = 65) received different forms of treatments. A total of 46.1% (of n = 65) searched redundant medical diagnostic procedures. The patients with decreased coping capacity over time obtained the best prognosis. Primary SVD is an ineffectively treated disorder. Recommendations for specific complaint-oriented psychotherapy programs were given.
authors.affiliation: Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany. regine.tschan@unimedizin-mainz.de
authors.forename: Regine
authors.initials: R
authors.lastname: Tschan
authors.forename: Christoph
authors.initials: C
authors.lastname: Best
authors.forename: Jörg
authors.initials: J
authors.lastname: Wiltink
authors.forename: Manfred E
authors.initials: ME
authors.lastname: Beutel
authors.forename: Marianne
authors.initials: M
authors.lastname: Dieterich
authors.forename: Annegret
authors.initials: A
authors.lastname: Eckhardt-Henn
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003299:Cooperative Behavior; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D004185:Disability Evaluation; D004244:Dizziness / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D005260:Female; D006306:Health Surveys; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014717:Vertigo / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy