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Patients’ psychological well-being and resilient coping protect from secondary somatoform vertigo and dizziness (SVD) 1 year after vestibular disease

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Abstract

Secondary somatoform dizziness and vertigo (SVD) is an underdiagnosed and handicapping psychosomatic disorder, leading to extensive utilization of health care and maladaptive coping. Few long-term follow-up studies have focused on the assessment of risk factors and little is known about protective factors. The aim of this 1-year follow-up study was to identify neurootological patients at risk for the development of secondary SVD with respect to individual psychopathological disposition, subjective well-being and resilient coping. In a prospective interdisciplinary study, we assessed mental disorders in n = 59 patients with peripheral and central vestibular disorders (n = 15 benign paroxysmal positional vertigo, n = 15 vestibular neuritis, n = 8 Menière’s disease, n = 24 vestibular migraine) at baseline (T0) and 1 year after admission (T1). Psychosomatic examinations included the structured clinical interview for DSM-IV, the Vertigo Symptom Scale (VSS), and a psychometric test battery measuring resilience (RS), sense of coherence (SOC), and satisfaction with life (SWLS). Subjective well-being significantly predicted the development of secondary SVD: Patients with higher scores of RS, SOC, and SWLS at T0 were less likely to acquire secondary SVD at T1. Lifetime mental disorders correlated with a reduced subjective well-being at T0. Patients with mental comorbidity at T0 were generally more at risk for developing secondary SVD at T1. Patients’ dispositional psychopathology and subjective well-being play a major predictive role for the long-term prognosis of dizziness and vertigo. To prevent secondary SVD, patients should be screened for risk and preventive factors, and offered psychotherapeutic treatment in case of insufficient coping capacity.

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Acknowledgments

We would like to thank the patients for their participation in the study. This work was supported by a grant of the Deutsche Forschungsgemeinschaft (EC 220/2-1).

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Authors and Affiliations

  1. Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany

    Regine Tschan, Manfred E. Beutel, Achim Knebel & Jörg Wiltink

  2. Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany

    Christoph Best

  3. Department of Neurology, Ludwig-Maximilians-University, Munich, Germany

    Marianne Dieterich

  4. Department of Psychosomatic Medicine, Bürgerhospital, Stuttgart, Germany

    Annegret Eckhardt-Henn

Authors
  1. Regine Tschan
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  2. Christoph Best
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  3. Manfred E. Beutel
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  4. Achim Knebel
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  5. Jörg Wiltink
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  6. Marianne Dieterich
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  7. Annegret Eckhardt-Henn
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Correspondence to Regine Tschan.

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Tschan, R., Best, C., Beutel, M.E. et al. Patients’ psychological well-being and resilient coping protect from secondary somatoform vertigo and dizziness (SVD) 1 year after vestibular disease. J Neurol 258, 104–112 (2011). https://doi.org/10.1007/s00415-010-5697-y

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  • DOI: https://doi.org/10.1007/s00415-010-5697-y

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