title: Health-related quality of life and emotional distress in patients with dizziness: a cross-sectional approach to disentangle their relationship.
abstract: BACKGROUND
  Dizziness is frequently encountered in medical practice, often takes a chronic course and can impair the health related quality of life (HRQoL). However results on the extent of this impairment of HRQoL are mixed. Furthermore, the relationship between dizziness and the HRQoL is only partially understood. The role of clinical symptoms of dizziness and psychosocial factors such as emotional distress on this relationship is for the most part unknown.
  
  
  METHODS
  The cross-sectional study evaluated the HRQoL in 203 patients suffering from dizziness, using the Medical Outcomes Studies 36-Item Short-Form Health-Survey (SF-36). The results were correlated with the severity of dizziness, using the Dizziness Handicap-Inventory (DHI), with emotional distress, using the Hospital Anxiety and Depression-Scale (HADS) and with further clinical symptoms and psychosocial parameters. In a multivariate hierarchical regression analysis associated variables which explain significant variance of the mental and physical HRQoL (MCS-36, PCS-36) were identified.
  
  
  RESULTS
  Patients suffering from dizziness showed a markedly reduced mental and physical HRQoL. Higher DHI and HADS scores were correlated with lower MCS-36 and PCS-36 scores. Taken together DHI and vertigo characteristics of dizziness explained 38% of the variance of PCS-36. Overall explained variance of PCS-36 was 45%. HADS and living with a significant other explained 66% of the variance of MCS-36 (overall variance explained: 69%).
  
  
  CONCLUSIONS
  Both the physical and mental HRQoL are significantly impaired in patients with dizziness. While the impairment in PCS-36 can be explained by clinical symptoms of the dizziness, MCS-36 impairment is largely associated with psychosocial factors. To improve the patient's overall well-being significantly and permanently doctors have to keep in mind both, the clinical symptoms and the psychosocial factors. Therefore, in addition to the physical examination doctors should integrate a basic psychological examination into the daily routine with dizziness patients.
authors: Department of Psychiatry and Psychotherapy, University Hospital Zurich, Culmannstrasse 8, Zurich CH-8091, Switzerland. steffi.weidt@usz.ch.
authors: Steffi
authors: S
authors: Weidt
authors: Annette B
authors: AB
authors: Bruehl
authors: Dominik
authors: D
authors: Straumann
authors: Stefan C A
authors: SC
authors: Hegemann
authors: Gerhard
authors: G
authors: Krautstrunk
authors: Michael
authors: M
authors: Rufer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004244:Dizziness / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires