Abstract
Patients who experience chronic dizziness are considered to be difficult to treat. Persisting symptoms of vertigo can be caused by recurrent organic as well as a variety of psychogenic factors, the latter usually being part of anxiety and depression disorders. Psychotherapeutic interventions can achieve improvements, the effects, however, in general do not persist over a longer time. The purpose of this study is to investigate the long-term effects of a symptom-related indoor treatment including neurotological and psychotherapeutic approaches as well as vestibular and balance rehabilitation. 23 indoor patients 16 male patients and 7 female., mean age 56.6 years (SD 12) with chronic vestibular symptoms (longer than six months), who were treated with neurotological counseling, psychotherapy, vestibular and balance rehabilitation and—if necessary—antidepressant drugs during a lengthy hospital stay [average 40 days (SD 14)], were re-examined. After a time period of at least one year (average 32 months; SD 15) they were asked to answer a questionnaire concerning post-therapeutic status of dizziness, symptoms and coping strategies as well as the Hospital Anxiety and Depression Score (HADS D). 18 of 23 patients (78%) reported a sustained reduction in their vertiginous symptoms. Four patients did not report a persistent improvement and one even got worse. Patients with a chronic form of dizziness can improve through a coordinated neurotologic and psychotherapeutic approach including vestibular and balance rehabilitation.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Brandt T, Huppert D, Dieterich M (1994) Phobic postural vertigo: a first follow-up. J Neurol 241(4):191–195
Bronstein AM (1995) Visual vertigo syndrome: clinical an posturography findings. J Neurol Neurosurg Psychiatry 59(5):472–476
Jacob RG, Woody SR, Clark DB (1993) Discomfort with space and motion: a possible marker of vestibular dysfunction by the situational characteristics questionnaire. J Psychopathol Behav Assess 15(4):299–325
Chronic Staab J, Dizziness Subjective (2012) Continuum 18(5):1118–1141
Staab J (2006) Assessment and management of psychological problems in the dizzy patient. Continuum 12(4):189–213
Eckhardt-Henn A, Tschan R, Best C, Dieterich M (2009) Somatoform syndromes of vertigo. Nervenarzt 80:909–917
Schmid G, Henningsen P, Dieterich M, Sattel H, Lahmann C (2011) Psychotherapy in dizziness: a systematic review. J Neurol Neurosurg Psychiatry 82:601–606
Holmberg J, Karlberg M, Harlacher U, Magnusson M (2007) One-year follow-up of cognitive behavioral therapy for phobic postural vertigo. J Neurol 254:1189–1192
Jacobson E (1938) Progressive relaxation. University of Chicago Press, Chicago
Herrmann Ch, Buss U, Snaith RP (1995) HADS-D—Hospital anxiety and depression scale—deutsche version: Ein Fragebogen zur Erfassung von Angst und Depressivität in der somatischen Medizin. Huber, Bern
Edelman S, Mahoney AE, Cremer PD (2012) Cognitive behavior therapy for chronic subjective dizziness: a randomized, controlled trial. Am J Otolaryngol 33(4):395–401
Mahoney A, Edelman S (2013) Cremer PD Cognitive behavior therapy for chronic subjective dizziness: longer-term gains and predictors of disability. Am J Otolaryngol 34(2):115–120
Tschan R, Eckhardt-Henn A, Scheurich V, Best C, Dieterich M, Beutel M (2012) Steadfast–effectiveness of a cognitive-behavioral self-management program for patients with somatoform vertigo and dizziness. Psychother Psychosom Med Psychol 62(3–4):111–119
Schaaf H, Holtmann H., Hesse G, Rienhoff N, Kolbe U, Brehmer D (2000) Reactive psychogenic dizziness in Menière’s disease. In: Sterkers O, Ferrary E, Daumann R, Sauvage J.P, Tran Ba Huy R (eds) Menière’s disease 1999—update. Proceedings of the 4th international Symposium of Menière’s disease Paris, France, April 11–14, 1999. Kugler Publikcations, The Hague. pp 505–511
Schaaf H, Haid CT (2003) Reactive psychogenic dizziness in Menière’s disease. Dtsch Arztebl 13:853–857
Cawthorne TE, Friedmann G (1969) Head movement exercises in the therapy of disorders of the equilibrium. Schweiz Med Wochenschr 99:156–158
Cooksey FS (1946) Rehabilitation in vestibular injuries. Proc R Soc Med 39:273–278
Author information
Authors and Affiliations
Corresponding author
Appendix
Appendix
Rights and permissions
About this article
Cite this article
Schaaf, H., Hesse, G. Patients with long-lasting dizziness: a follow-up after neurotological and psychotherapeutic inpatient treatment after a period of at least 1 year. Eur Arch Otorhinolaryngol 272, 1529–1535 (2015). https://doi.org/10.1007/s00405-014-3447-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-014-3447-y