Treatment of phobic postural vertigo - A controlled study of cognitive-behavioral therapy and self-controlled desensitization
Treatment of phobic postural vertigo - A controlled study of cognitive-behavioral therapy and self-controlled desensitization
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DOI：
10.1007/s00415-005-0050-6
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发表时间：
2006-04-01
影响因子：
6
通讯作者：
Magnusson, M
中科院分区：
文献类型：
--
作者：
Holmberg, J;Karlberg, M;Magnusson, M
在平衡临床实践中，恐怖性姿势性眩晕是一个术语，用于定义通常因前庭障碍而出现头晕和回避行为的人群。它被描述为头晕病房中中年患者最常见的头晕形式。焦虑症在前庭障碍患者中很常见。认知行为疗法是治疗焦虑症的有效方法，前庭康复训练对前庭障碍有效。本研究比较了额外的认知行为治疗与自我管理的前庭康复训练的效果与恐惧性姿势性眩晕的人群的效果。39例患者被招募的耳神经病学调查提到的人口。采用头晕障碍量表、眩晕症状量表、眩晕障碍问卷、医院焦虑抑郁量表评定疗效。所有患者均进行自我治疗干预，其基础是通过前庭康复训练进行自我暴露的教育和建议。每两名患者中有一名接受了额外的认知行为治疗，其中15名接受自我治疗的患者和16名接受认知行为治疗的患者完成了研究。认知行为治疗组在眩晕障碍问卷和医院焦虑抑郁量表及其各分量表上的疗效均显著高于自我治疗组，说明认知行为治疗对恐怖性体位性眩晕患者有额外的疗效。建议采取包括药物治疗、认知行为治疗和物理治疗在内的多学科综合治疗方法。
In balance clinic practice, phobic postural vertigo is a term used to define a population with dizziness and avoidance behavior often as a consequence of a vestibular disorder. It has been described as the most common form of dizziness in middle aged patients in dizziness units. Anxiety disorders are common among patients with vestibular disorders. Cognitive-behavioral therapy is an effective treatment for anxiety disorders, and vestibular rehabilitation exercises are effective for vestibular disorders. This study compared the effect of additional cognitive-behavioral therapy for a population with phobic postural vertigo with the effect of self-administered vestibular rehabilitation exercises.39 patients were recruited from a population referred for otoneurological investigation. Treatment effects were evaluated with the Dizziness Handicap Inventory, Vertigo Symptom Scale, Vertigo Handicap Questionnaire, and Hospital Anxiety and Depression Scale. All patients had a self treatment intervention based on education about the condition and recommendation of self exposure by vestibular rehabilitation exercises. Every second patient included was offered additional cognitive behavioral therapy.Fifteen patients with self treatment and 16 patients with cognitive-behavioral treatment completed the study. There was significantly larger effect in the group who received cognitive behavioral therapy than in the self treatment group in Vertigo Handicap Questionnaire and the Hospital Anxiety and Depression scale and its subscales.Cognitive-behavioral therapy has an additional effect as treatment for a population with phobic postural vertigo. A multidisciplinary approach including medical treatment, cognitive-behavioral therapy and physiotherapy is suggested.