title: Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness.
abstract: BACKGROUND
  Vertigo and dizziness are often not fully explained by an organic illness, but instead are related to psychiatric disorders. This study aimed to evaluate psychiatric comorbidity and assess psychosocial impairment in a large sample of patients with a wide range of unselected organic and non-organic (ie, medically unexplained) vertigo/dizziness syndromes.
  
  
  METHODS
  This cross-sectional study involved a sample of 547 patients recruited from a specialised interdisciplinary treatment centre for vertigo/dizziness. Diagnostic evaluation included standardised neurological examinations, structured clinical interview for major mental disorders (SCID-I) and self-report questionnaires regarding dizziness, depression, anxiety, somatisation and quality of life.
  
  
  RESULTS
  Neurological diagnostic workup revealed organic and non-organic vertigo/dizziness in 80.8% and 19.2% of patients, respectively. In 48.8% of patients, SCID-I led to the diagnosis of a current psychiatric disorder, most frequently anxiety/phobic, somatoform and affective disorders. In the organic vertigo/dizziness group, 42.5% of patients, particularly those with vestibular paroxysmia or vestibular migraine, had a current psychiatric comorbidity. Patients with psychiatric comorbidity reported more vertigo-related handicaps, more depressive, anxiety and somatisation symptoms, and lower psychological quality of life compared with patients without psychiatric comorbidity.
  
  
  CONCLUSIONS
  Almost half of patients with vertigo/dizziness suffer from a psychiatric comorbidity. These patients show more severe psychosocial impairment compared with patients without psychiatric disorders. The worst combination, in terms of vertigo-related handicaps, is having non-organic vertigo/dizziness and psychiatric comorbidity. This phenomenon should be considered when diagnosing and treating vertigo/dizziness in the early stages of the disease.
authors: Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany.
authors: Claas
authors: C
authors: Lahmann
authors: Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany.
authors: Peter
authors: P
authors: Henningsen
authors: German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany Department of Clinical Neuroscience, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany.
authors: Thomas
authors: T
authors: Brandt
authors: German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany Department of Neurology, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany.
authors: Michael
authors: M
authors: Strupp
authors: German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany Department of Neurology, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany.
authors: Klaus
authors: K
authors: Jahn
authors: German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany Department of Neurology, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany Munich Cluster of Systems Neurology (SyNergy), Munich, Germany.
authors: Marianne
authors: M
authors: Dieterich
authors: Department of Psychosomatic Medicine and Psychotherapy, Klinikum Stuttgart, Stuttgart, Germany.
authors: Annegret
authors: A
authors: Eckhardt-Henn
authors: German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany Department of Neurology, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany.
authors: Regina
authors: R
authors: Feuerecker
authors: Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors: Andreas
authors: A
authors: Dinkel
authors: Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians-Universität, Munich, Germany.
authors: Gabriele
authors: G
authors: Schmid
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004185:Disability Evaluation; D004244:Dizziness / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D009460:Neurologic Examination; D057566:Self Report; D012917:Social Adjustment; D014717:Vertigo / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*
keywords: SOMATISATION DISORDER; VERTIGO