Psychological evaluation in vertiginous patients

Abstract

Four psychological tests, namely the Cornell Medical Index (CMI), the Manifest Anxiety Scale (MAS), the self-rating depression scale (SDS), and the self-rating anxiety scale (SAS) were performed to investigate the role of psychological factors in vertigo, in a study of 111 vertiginous patients and 81 controls. Vertiginous patients comprised the following three groups: 56 vertebrobasilar insufficiency (VBI group), 29 autonomic nervous dysfunction (AND group), and 26 Ménière's disease (MD group). The incidence of abnormal scores by CMI and SAS in the vertiginous patients was significantly higher than that in the controls (p < 0.01). No significant difference between the vertiginous patients and the controls was observed with respect to MAS and SDS scores. The abnormal rates by CMI in the VBI and AND groups were significantly higher than in controls (p < 0.01). Also, the abnormal rates by SAS in the VBI and MD groups were significantly higher than in controls (VBI group: p < 0.01, MD group: p < 0.05). However, no significant differences between the three groups of vertiginous patients and controls were found with respect to MAS and SDS scores. The average score from other psychological tests in the CMI-abnormal group was significantly higher than that in the CMI-normal group (p < 0.01). There were significant correlations between the MAS and SDS, MAS and SAS, and SDS and SAS scores (r = 0.682-0.688, p < 0.01). The matched data rate between the psychological tests was about 70-80%. Considering the results of MAS and SAS, vertigo induces anxiety forwards vertigo, and thereby initiates a vicious cycle. In vertiginous patients, CMI and SAS are most useful for determining whether or not psychological factors play a role in the onset of and persistence of vertigo. But CMI consist of 195 factors, and therefore, is time concerning. On the other hand, SAS has 20 factors and takes only 5 minutes to complete, thus, SAS is more suitable for screening psychological factors.