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Vestibular deﬁcits and psychological factors correlating to dizziness handicap and symptom severity

Research output: Contribution to journalArticle

Original languageEnglish
Number of pages8
JournalJournal of Psychosomatic Research
Publication statusPublished - 21 Feb 2020

King's Authors


Objective: To determine the relative contribution of demographic variables, objective testing and psychological factors in explaining the variance in dizziness severity and handicap. Methods: One-hundred and eighty-ﬁve consecutive patients on the waiting list to attend a diagnostic appointment in a tertiary neuro-otology clinic with a primary complaint of vertigo or dizziness completed a crosssectional survey. Primary outcomes were the Dizziness Handicap Inventory and the vertigo subscale of the Vertigo Symptom Scale-Short Form. Psychological questionnaires assessed anxiety and depressive symptoms, illness perceptions, cognitive and behavioural responses to symptoms, beliefs about emotions and psychological vulnerability. Patients alsounderwent standardised audio-vestibular investigations and tests to reach adiagnosis at appointment. Results: Objective disease characteristics were not associated with handicap and only the presence of vestibular dysfunction on one test (caloric) was associated with symptom severity. Almost all the psychological factors were correlated with dizziness outcomes. The total hierarchical regression model explained 63% of the variance indizziness handicap, and53%was explained bythe psychological variables. The regression modelforsymptom severity explained 36%of the variance,and 30% was explained bythe psychological factors. In adjusted models, factors associated with dizziness handicap included age, female gender, distress, symptom focusing, embarrassment, avoidance, and beliefs about negative consequences. Fear avoidance was the only independent correlate in the fully adjusted model of symptom severity. Conclusion: Self-reported dizziness severity and handicap are not correlated with clinical tests of vestibular deﬁcits butare associated with psychological factors including anxiety, depression, illness perceptions, cognitive and behavioural responses.

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