Abstract
Objectives: (1) To assess whether neuroticism, state anxiety, and body vigilance are higher in patients with persistent postural-perceptual dizziness (PPPD) compared to a recovered vestibular patient group and a non-dizzy patient group; (2) To gather pilot data on illness perceptions of patients with PPPD.Materials and Methods: 15 cases with PPPD and two control groups: (1) recovered vestibular patients (n = 12) and (2) non-dizzy patients (no previous vestibular insult, n = 12). Main outcome measures: Scores from the Big Five Inventory (BFI) of personality traits, Generalized Anxiety Disorder - 7 (GAD-7) scale, Body Vigilance Scale (BVS), Dizziness Handicap Inventory (DHI), modified Vertigo Symptom Scale (VSS) and Brief Illness Perception Questionnaire (BIPQ).Results: Compared to non-dizzy patients, PPPD cases had higher neuroticism (p = 0.02), higher introversion (p = 0.008), lower conscientiousness (p = 0.03) and higher anxiety (p = 0.02). There were no differences between PPPD cases and recovered vestibular patients in BFI and GAD-7. PPPD cases had higher body vigilance to dizziness than both control groups and their illness perceptions indicated higher levels of threat than recovered vestibular patients.Conclusion: PPPD patients showed statistically significant differences to non-dizzy patients, but not recovered vestibular controls in areas such as neuroticism and anxiety. Body vigilance was increased in PPPD patients when compared with both recovered vestibular and non-dizzy patient groups. PPPD patients also exhibited elements of negative illness perception suggesting that this may be the key element driving the development of PPPD. Large scale studies focusing on this area in the early stages following vestibular insult are needed.
Highlights
The diagnosis persistent postural-perceptual dizziness (PPPD) entered the 11th edition of the World Health Organization’s International Classification of Diseases (ICD-11 beta draft) in 2015 following a consensus document on its diagnostic criteria created by Bárány Society for the International Classification of Vestibular Disorders (ICVD) and the criteria for its dignosis are outlined in Table 1 [1,2,3]
Eighteen patients who had been given a diagnosis of PPPD in accordance with ICVD criteria (Table 1) during that time period were consecutively asked to take part in the study
The first group consisted of patients who had sustained a peripheral vestibular insult but did not develop PPPD
Summary
The diagnosis persistent postural-perceptual dizziness (PPPD) entered the 11th edition of the World Health Organization’s International Classification of Diseases (ICD-11 beta draft) in 2015 following a consensus document on its diagnostic criteria created by Bárány Society for the International Classification of Vestibular Disorders (ICVD) and the criteria for its dignosis are outlined in Table 1 [1,2,3]. PPPD is a relatively new diagnosis and to date it is still not clear what predisposes some people to it following known triggers such as acute, episodic, or chronic vestibular syndromes, other neurological or medical illnesses, or psychological distress. A prospective study found that psychological distress predicted severity of dizziness-related handicap among patients with various vestibular disorders in the 12 months following tertiary consultation [9]. 1. Symptoms last for prolonged dizziness, unsteadiness, or (hours long) periods of time non-spinning vertigo are present but may wax and wane in on most days for 3 months or severity more
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