Cognitive-behavioural therapy for chronic subjective dizziness: Predictors of improvement in Dizziness Handicap Inventory at 6 months posttreatment

Abstract

Background: Chronic subjective dizziness (CSD), which was superseded by persistent postural-perceptual dizziness as of 2017, has a great impact on patients’ quality of life.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.