title: Vertigo "in the pink": The impact of female gender on psychiatric-psychosomatic comorbidity in benign paroxysmal positional vertigo patients.
abstract: BACKGROUND
  Comorbidity between vestibular and psychiatric disorders in predisposed individuals is underestimated, untreated, and may result in chronicization and poor quality of life. There are few studies concerning the type and the prevalence of psychiatric-psychosomatic distress in patients with benign paroxysmal positional vertigo (BPPV).
  
  
  OBJECTIVE
  The aim of this study was to evaluate psychiatric-psychosomatic comorbidities, in particular anxiety, depression, somatization symptoms, and alexithymia, in a group of BPPV patients compared with healthy subjects, and according to gender.
  
  
  METHODS
  Case-control study comparing 92 BPPV patients recruited at the ENT Unit of Modena General Hospital between November 2007 and December 2010, and 141 healthy controls. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Diagnostic Criteria for Psychosomatic Research (DCPR), Brief Symptom Inventory (BSI), and Toronto Alexithymia Scale (TAS-20) were used to perform psychometric assessment.
  
  
  RESULTS
  BPPV patients scored higher than controls, with statistical significance, at BDI, BSI somatization, anxiety, and phobic anxiety subscales, and STAI state anxiety; a larger proportion of BPPV patients suffered from clinically significant BDI depressive symptomatology; DCPR disease phobia, functional somatic symptoms secondary to a psychiatric disorder, and demoralization were more common among BPPV subjects. High levels of symptomatology were still found among BPPV female patients, but not among males, even after controlling for symptom severity.
  
  
  CONCLUSIONS
  Affective symptomatology, such as depression, demoralization, phobia and anxiety, and somatization, were significantly prevalent in BPPV patients, and female gender may be a predisposing factor.
authors.affiliation: Department of Clinical-Diagnostic Medicine and Public Health, Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy. Electronic address: silvia.ferrari@unimore.it.
authors.forename: Silvia
authors.initials: S
authors.lastname: Ferrari
authors.affiliation: Department of Clinical-Diagnostic Medicine and Public Health, Section of ENT, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Monzani
authors.affiliation: Department of Clinical-Diagnostic Medicine and Public Health, Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Baraldi
authors.affiliation: Department of Clinical-Diagnostic Medicine and Public Health, Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Simoni
authors.affiliation: Department of Clinical-Diagnostic Medicine and Public Health, Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy.
authors.forename: Giada
authors.initials: G
authors.lastname: Prati
authors.affiliation: Department of Clinical-Diagnostic Medicine and Public Health, Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy.
authors.forename: Matilde
authors.initials: M
authors.lastname: Forghieri
authors.affiliation: Department of Clinical-Diagnostic Medicine and Public Health, Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Rigatelli
authors.affiliation: Department of Clinical-Diagnostic Medicine and Public Health, Section of ENT, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Genovese
authors.affiliation: Human Resources, AUSL, Reggio Emilia, Reggio Emilia, Italy; International PhD School in Clinical and Experimental Medicine, University of Modena, Reggio Emilia, Modena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pingani
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000453:epidemiology*; D000368:Aged; D065635:Benign Paroxysmal Positional Vertigo / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010698:Phobic Disorders / Q000453:epidemiology*; D011602:Psychophysiologic Disorders / Q000453:epidemiology*; D012737:Sex Factors; D013001:Somatoform Disorders / Q000453:epidemiology*; D055815:Young Adult