Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness
Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness
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DOI：
10.1136/jnnp-2014-307601
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发表时间：
2015-03-01
影响因子：
11
通讯作者：
Schmid, Gabriele
中科院分区：
文献类型：
--
作者：
Lahmann, Claas;Henningsen, Peter;Schmid, Gabriele
背景眩晕和眩晕通常不能完全由器质性疾病解释，而是与精神疾病有关。本研究的目的是评估精神共病和评估心理社会障碍的患者大样本范围的器质性和非器质性（即医学上无法解释的）眩晕/头晕syndrome.Methods这一横断面研究涉及的样本547例患者从一个专门的跨学科治疗中心招募眩晕/头晕。诊断评估包括标准化的神经系统检查，结构化的主要精神障碍（SCID-I）和自我报告的问卷调查，头晕，抑郁，焦虑，躯体化和生活quality.Results神经系统诊断检查发现器质性和非器质性眩晕/头晕的患者，分别为80.8%和19.2%。在48.8%的患者中，SCID-I导致了当前精神障碍的诊断，最常见的是焦虑/恐惧症，躯体形式和情感障碍。在器质性眩晕/头晕组中，42.5%的患者，特别是前庭性阵发性或前庭性偏头痛患者，目前有精神病合并症。精神科合并症患者报告更多的眩晕相关障碍，更多的抑郁，焦虑和躯体化症状，心理生活质量较低的患者相比，没有精神科合并症。结论几乎一半的眩晕/头晕患者患有精神科合并症。与无精神疾病的患者相比，这些患者表现出更严重的心理社会障碍。就眩晕相关障碍而言，最差的组合是非器质性眩晕/头晕和精神共病。在疾病早期诊断和治疗眩晕/头晕时应考虑这种现象。
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.