Perceived illness consequences predict the long-term course of handicap in patients with vertigo and dizziness beyond vestibular abnormality

Johannes Wolf; Karina Limburg; Heribert Sattel; Claas Lahmann

doi:10.1016/j.jpsychores.2023.111401

Perceived illness consequences predict the long-term course of handicap in patients with vertigo and dizziness beyond vestibular abnormality

J Psychosom Res. 2023 Sep:172:111401. doi: 10.1016/j.jpsychores.2023.111401. Epub 2023 Jun 8.

Authors

Johannes Wolf¹, Karina Limburg², Heribert Sattel³, Claas Lahmann⁴

Affiliations

¹ Department of Psychiatry and Psychotherapy, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany. Electronic address: johannes.wolf@med.uni-muenchen.de.
² Department of Conservative Orthopedics, Manual Medicine, and Pain Medicine, SANA Hospital, Munich, Germany.
³ Department of Psychosomatic Medicine and Psychotherapy, Hospital Rechts der Isar, Technical University Munich, Germany.
⁴ Department of Psychosomatic Medicine and Psychotherapy, University Hospital Freiburg, Albert-Ludwigs-University Freiburg, Germany.

PMID: 37315402
DOI: 10.1016/j.jpsychores.2023.111401

Abstract

Objective: Vertigo and dizziness (VD) affect one third of the population during their lifetime. VD patients are oftentimes severely handicapped. One current study showed that illness perceptions, emotional as well as behavioral responses to illness were associated with VD-related handicap at 3-months follow-up. However, no study has yet investigated this association for a period longer than six months. This study aimed to investigate long-term associations of cognitive, emotional, and behavioral factors with VD-related handicap.

Methods: In a naturalistic longitudinal study design, n = 161 patients with VD were examined at baseline, at 6-months follow-up, and at 12-months follow-up. Participants underwent neurological and psychiatric examinations as well as comprehensive psychological assessments using self-report questionnaires.

Results: During the study period VD-related handicap decreased significantly (Cohen's d = .35, p < .001). Cognitive, emotional, and behavioral factors remained without significant change during the study period. Vestibular testing as well as the type of diagnosis were not associated with changes in VD-related handicap. Changes in perceived illness consequences (ß = .265, p < .001), depression (ß = .257, p < .001), and anxiety (ß = .206, p = .008) significantly predicted the course of VD-related handicap over 12 months, while the presence vs. absence of vestibular abnormality did not.

Conclusion: Our results extend findings that cognitive and emotional factors including perceived illness consequences, depression, and anxiety are associated with the long-term course of VD-related handicap and may provide therapeutic targets to improve long-term outcomes in patients with VD.

Keywords: Dizziness; Handicap; Illness perceptions; Outcome; Vertigo.