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Background: Chronic subjective dizziness (CSD), which was superseded by persistent postural-perceptual dizziness as of 2017, has a great impact on patients' quality of life. Cognitive-behavioural therapy (CBT) is a promising treatment, with demonstrated effectiveness as a CSD treatment; however, no studies have examined positive predictors of its effectiveness in the long term. Aims/objectives: This study aimed to examine predictors of improvement in the Dizziness Handicap Inventory (DHI) in patients with CSD at 6 months after CBT. Materials and methods: Thirty-seven patients with CSD who were recruited from April 2012 to November 2014 and completed group CBT were analysed. Single and multiple regression analyses with forward-backward stepwise model selection method was used to examine the independent predictors of long-term improvement in the change score of DHI. Results: Presence or absence of comorbid anxiety disorders ( p  = .023) was a significant positive predictive factor for improvement of DHI from pretreatment to 6-month follow-up. Conclusions and significance: The presence of comorbid anxiety disorders predicted considerable improvement of DHI from pretreatment to 6-month follow-up. Group therapy including interoceptive exposure using vestibular rehabilitation, along with psychoeducation and behavioural experiments with graded exposure, may be particularly suitable in treating patients with CSD.

Objective: Vertigo and dizziness are often not fully explained by organic illnesses, but instead may be related to psychiatric disorders. It is important to determine the types of psychiatric comorbidities that are frequent in cases of intractable dizziness., Method: The study subjects were 90 patients who had experienced intractable dizziness for more than three months and were referred to a psychiatrist when their symptoms could not be fully explained based on their physical illness. The patients' final diagnosis and questionnaire (DHI,SDS and STAI) scores were evaluated., Results: Seventy percent (63/90) of patients with intractable dizziness had been diagnosed as having psychiatric conditions by the study psychiatrists. The most common diagnosis was unspecified depressive disorder., Conclusions: Psychiatric comorbidities seem to be more prevalent in certain subgroups of organic dizziness. We found a higher rate of depressive disorders in the sequelae of sudden deafness and migraine-related dizziness.

Conclusions: The comorbidity of sleep disturbance with chronic dizziness in women was related to the intensity of distress and interference with their lives due to dizziness, although it was not related to objective variables of dizziness. In addition, the presence of sleep disturbance was associated with severe anxiety and depression, and low health-related quality-of-life (QoL)., Objectives: This study investigated the effect of sleep disturbance in patients with chronic dizziness on symptoms of dizziness, handicaps due to dizziness, health-related QoL, and emotional distress., Method: The participants of this study were 252 in-patients with chronic dizziness. Participants completed questionnaires containing the Dizziness Handicap Inventory (DHI, three sub-scales: Physical [DHI-P], Emotional [DHI-E], and Functional [DHI-F] scores), Pittsburgh sleep quality index (PSQI-J), Hospital Anxiety and Depression Scale (HADS), and Medical Outcomes Study 8-items Short Form Health Survey (SF-8, health-related QoL). The participants then underwent gravity center fluctuation measurement as an objective indicator of the severity of dizziness., Results: The prevalence of sleep disturbance (PSQI-J global score ≧6) was 65.1% in these participants. Two-way ANOVA of the DHI scores showed significant interaction between sleep disturbance and sex in DHI total, DHI-E score, and DHI-F score, indicating that these scores were higher in women with sleep disturbance. Regarding DHI-P score, only the main effect of sex was significant (women > men). Sleep disturbance had no significant effect on objective indicators of severity of dizziness. Patients with sleep disturbance had significantly higher HADS scored and a lower SF-8 scored than patients without sleep disturbance.

Conclusions: The Self-Rating Depression Score (SDS) is a useful metric for identifying patients with possible psychiatric disorders., Objective: A dilemma commonly encountered by otolaryngologists is how to diagnose and treat depression and anxiety disorders in patients who have dizziness or Ménière's disease., Methods: We administered the SDS and Hospital Anxiety and Depression Scale (HADS) to patients with dizziness (n = 116) or Ménière's disease (n = 22). Overall, 31 and 9 patients, respectively, had SDS ≥ 41. We investigated the correlation between the two questionnaire scores and the relationship between scores and a diagnosis of depression by a psychiatrist., Results: We referred 12 patients with dizziness and 4 with Ménière's disease to a psychiatrist. The most common psychiatric comorbidities were anxiety disorder and major depression. Overall, 7 of the 12 patients who had dizziness and all 4 patients with Ménière's disease were diagnosed with major depression. Patients with an SDS ≥ 41 and ≥ 11 on the D portion of HADS were likely to be diagnosed with major depression (9 of 11). No psychiatric disorders were diagnosed in patients with an SDS < 41. No specific characteristics were identified by HADS in patients with a psychiatric comorbidity.

Conclusion: Chronic subjective dizziness (CSD) is frequent and affects twice as many women as men. Anxiety is a strong predisposing factor. The pathophysiologic concept of this disorder assumes that balance function and emotion share common neurologic pathways, which might explain that the balance disorder can provoke fear and vice versa, giving rise to a problem in perception of space and motion. In anxious patients this can turn into a space and motion phobia, with avoidance behaviour., Objective: CSD is a diagnosis based on the hypothesis of an interaction between the vestibular system and the psychiatric sphere. Patients complain of chronic imbalance, worsened by visual motion stimulation, and frequently suffer from anxiety. Vestibular examination reveals no anomalies. We evaluated the incidence and characteristics of CSD in patients referred to our neuro-otology centre (tertiary hospital outpatient clinic)., Subjects and Methods: This was a retrospective study of 1552 consecutive patients presenting with vertigo. CSD was diagnosed in 164 patients (female:male=111:53)., Results: CSD represents 10.6% of the dizzy patients in our clinic. Psychiatric disorder, mainly anxiety, was found in 79.3% of the cases. Other frequently associated factors were fear of heights and former vestibular lesion (healed). In all, 79.0% of the patients with CSD had poor balance performance on dynamic posturography testing.

Conclusion: Elderly patients with chronic dizziness had a poor HRQoL, which could be successfully assessed using the SF-36, a generic health-status instrument. The frequency of dizziness and comorbid psychological distress were predictive of impairment in QoL., Objectives: To evaluate health-related quality of life (HRQoL) and its relationship to characteristics of dizziness in elderly persons with chronic dizziness., Material and Methods: A standardized dizziness questionnaire was used to evaluate characteristics of dizziness as well as medical, functional and demographic data in 197 consecutive patients with chronic dizziness aged > or =60 years. HRQoL was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS)., Results: Compared with normative data, results from patients with dizziness indicated a pervasive multidimensional decline in SF-36 scores. This decline was most notable in terms of role limitations in the physical and emotional dimensions. The frequency of attacks of dizziness correlated with perceived disability. Patients with chronic dizziness also had great psychological distress, as measured by the HADS score, which had a detrimental influence on their QoL.