Abstract
BackgroundAn important question influencing therapy for dizziness is whether the strengths of the relationships of emotional and functional aspects of dizziness to 1) anxiety and other mental states, 2) perceived state of health (SoH) and quality of life (QoL) are different in patients with and without normal balance control. We attempted to answer this question by examining these dimensions’ regression strengths with Dizziness Handicap Inventory (DHI) scores.MethodsWe divided 40 patients receiving group cognitive behavioural therapy (CBT) and vestibular rehabilitation for dizziness, into 2 groups: dizziness only (DO) and normal balance control; dizziness and a quantified balance deficit (QBD). Group-wise, we first performed stepwise multivariate regression analysis relating total DHI scores with Brief Symptom Inventory (BSI) sub-scores obtained pre- and post-therapy. Then, regression analysis was expanded to include SoH, QoL, and balance scores. Finally, we performed regressions with DHI sub-scores.ResultsIn both groups, the BSI phobic anxiety state score was selected first in the multivariate regression analysis. In the DO group, obsessiveness/compulsiveness was also selected. The correlation coefficient, R, was 0.74 and 0.55 for the DO and QBD groups, respectively. When QoL and SoH scores were included, R values increased to 0.86 and 0.74, explaining in total 74, and 55% of the DHI variance for DO and QBD groups, respectively. Correlations with balance scores were not significant (R ≤ 0.21). The psychometric scores selected showed the strongest correlations with emotional DHI sub-scores, and perceived QoL and SoH scores with functional DHI sub-scores.ConclusionsOur findings suggest that reducing phobic anxiety and obsessiveness/compulsiveness during CBT may improve emotional aspects of dizziness and targeting perceived SoH and QoL may improve functional aspects of dizziness for those with and without normal balance control.
Highlights
Dizziness and vertigo have a profound negative effect on the daily activities of 10% of those younger than 60 and 20% of those older than 60 years of age [1]
Our findings suggest that reducing phobic anxiety and obsessiveness/compulsiveness during cognitive behavioural therapy (CBT) may improve emotional aspects of dizziness and targeting perceived state of health (SoH) and quality of life (QoL) may improve functional aspects of dizziness for those with and without normal balance control
The major finding of this study was to demonstrate for two different groups of patients with dizziness, one with and the other without accompanying balance deficits, similar relationships of the patients’ perceived impact of dizziness, as recorded by Dizziness Handicap Inventory (DHI) scores, to phobic anxiety and perceived impaired QoL scores
Summary
Dizziness and vertigo have a profound negative effect on the daily activities of 10% of those younger than 60 and 20% of those older than 60 years of age [1]. These two symptoms are among the most commonly occurring symptoms of patients examined by neurologists [2]. A third approach is to combine CBT with VR Using this approach, Yardley et al [1] were able to show improvements in psychometric subscores thereby confirming the suggestions of others [3, 4] of the suitability of this treatment for both patients with and without an accompanying balance deficit [11]. We attempted to answer this question by examining these dimensions’ regression strengths with Dizziness Handicap Inventory (DHI) scores
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