Abstract
BackgroundDizziness is frequently encountered in medical practice, often takes a chronic course and can impair the health related quality of life (HRQoL). However results on the extent of this impairment of HRQoL are mixed. Furthermore, the relationship between dizziness and the HRQoL is only partially understood. The role of clinical symptoms of dizziness and psychosocial factors such as emotional distress on this relationship is for the most part unknown.MethodsThe cross-sectional study evaluated the HRQoL in 203 patients suffering from dizziness, using the Medical Outcomes Studies 36-Item Short-Form Health-Survey (SF-36). The results were correlated with the severity of dizziness, using the Dizziness Handicap-Inventory (DHI), with emotional distress, using the Hospital Anxiety and Depression-Scale (HADS) and with further clinical symptoms and psychosocial parameters. In a multivariate hierarchical regression analysis associated variables which explain significant variance of the mental and physical HRQoL (MCS-36, PCS-36) were identified.ResultsPatients suffering from dizziness showed a markedly reduced mental and physical HRQoL. Higher DHI and HADS scores were correlated with lower MCS-36 and PCS-36 scores. Taken together DHI and vertigo characteristics of dizziness explained 38% of the variance of PCS-36. Overall explained variance of PCS-36 was 45%. HADS and living with a significant other explained 66% of the variance of MCS-36 (overall variance explained: 69%).ConclusionBoth the physical and mental HRQoL are significantly impaired in patients with dizziness. While the impairment in PCS-36 can be explained by clinical symptoms of the dizziness, MCS-36 impairment is largely associated with psychosocial factors. To improve the patient’s overall well-being significantly and permanently doctors have to keep in mind both, the clinical symptoms and the psychosocial factors. Therefore, in addition to the physical examination doctors should integrate a basic psychological examination into the daily routine with dizziness patients.
Highlights
Dizziness is frequently encountered in medical practice, often takes a chronic course and can impair the health related quality of life (HRQoL)
In the current etiologically heterogeneous group of patients suffering from dizziness both sum scales of the Medical outcomes studies 36-item short-form health survey (SF-36) were significantly lower than normative values of the German population (MCS-36: t = −9.0, df = 171, p < 0.001; PCS-36: t = −12.2; df = 171, p < 0.001)
The current study aimed at differentiating and determining the association between clinical characteristics, psychosocial factors, and the HRQoL in patients with dizziness. In this etiologically heterogeneous group of patients suffering from dizziness, HRQoL was markedly impaired compared to the general population
Summary
Dizziness is frequently encountered in medical practice, often takes a chronic course and can impair the health related quality of life (HRQoL). Dizziness is more common in women [2,5] It is associated with other psychological and physical comorbidities [6,7]. Its origin can be vestibular, The health related quality of life (HRQoL) is a multidimensional concept, which reflects core components of functioning (e.g. physical, psychological/emotional and social functioning) in the context of medical conditions [15]. HRQoL measurements evaluate the impact of medical conditions on subjective well-being [16]. These measurements are suggested as outcome measures in clinical trials and for assessing the burden of clinical conditions by comparing clinical patients with the general population [16]. One measure assessing HRQoL is the Medical Outcomes Studies 36-Item Short-Form Health Survey (SF-36) [17]
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