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Psychological assessment of individuals with Mal de Débarquement Syndrome

Abstract

Objective

To report on the psychological, personality, and behavioral profiles of individuals with persistent Mal de Débarquement Syndrome (MdDS).

Materials and methods

Individuals with MdDS who participated in neuromodulation clinical trials between May 2013 and June 2019 completed a series of standardized psychological questionnaires and underwent the Structural Clinical Interview for DSM-IV-TR (SCID) for specific psychiatric diagnoses. All data reported are from baseline assessments prior to any study interventions. Scores were compared to population norms for adult women.

Results

Complete datasets were available for 55 women. Mean age of onset of MdDS was 49.0 ± 11.9 years (range 22–69 years) and median duration of illness of 22 months (6 months–20 years). SCID results were as follows: healthy (48.1%), any lifetime Major Depressive Disorder (35.2%, 7.4% current); any lifetime history of anxiety disorder (11.1%); any lifetime substance use disorders (18.5%, 0% current). Compared to population norms, the MdDS group scored significantly higher on the Patient Health Questionnaire-9 depression scale and the Generalized Anxiety Disorder 7 (GAD-7) anxiety scale, but only the GAD-7 correlated with symptom severity. The NEO-Five Factor Inventory for personality, Positive and Negative Affect Schedule, Behavioral Inhibition System/Behavioral Activation System Scale, and the Empathy Quotient metrics did not correlate with duration of illness. Disability assessed by the 12-item World Health Organization Disability Assessment Schedule 2.0 was 25.7 ± 6.7, comparable to reports for concussion. Disability correlated with severity of depression, anxiety, neuroticism, and affect but not to severity of MdDS.

Conclusions

Psychological profiles of MdDS relate to disability but not to duration of illness.

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Availability of data and materials

The data that support the findings of this study are openly available in Harvard Dataverse at http://doi.org/10.7910/HV8N8G.

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Funding

This work was supported by the Laureate Institute for Brain Research, the William K. Warren Foundation, and the MdDS Balance Disorders Foundation (YHC).

Author information

Affiliations

Authors

Contributions

All authors were involved in the design, data collection, and/or analysis of the data. Manuscript draft preparation, editing, and review were performed by JR, DG, BD, and YHC.

Corresponding author

Correspondence to Yoon-Hee Cha.

Ethics declarations

Conflicts of interest

The authors report no financial or ethical conflicts of interest in the execution of this study.

Ethics statement

This study was carried out in accordance with the recommendations of Western IRB. All participants gave written informed consent in accordance with the Declaration of Helsinki [3].

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplemental Figure 1.

DHI correlation to the MBRS. MBRS scores had a significant negative correlation to the total DHI score (A) and the DHI emotional subscale (C) but not the functional (B) or physical (D) subscales. (PDF 34 KB)

Supplemental Figure 2.

PHQ-9 questions identified in the Cognitive-Affective or Somatic domains. Participants score each question from “0” (not at all) to “3” (nearly every day) for the following nine questions: Q1. Little interest or pleasure in doing things; Q2. Feeling down, depressed, or hopeless; Q3. Trouble falling or staying asleep, or sleeping to much; Q4. Feeling tired or having little energy; Q5. Poor appetite or overeating; Q6. Feeling bad about yourself – or that you are a failure or have let yourself or your family down; Q7. Trouble concentrating on things, such as reading the newspaper or watching television; Q8. Moving or speaking so slowly that other people could have noticed? Or the opposite – being so fidgety or restless that you have been moving around a lot more than usual; Q9. Thoughts that you would be better off dead or of hurting yourself in some way. (PDF 13 KB)

Appendix

Appendix

Mal de Débarquement syndrome symptom severity scale

  1. 1.

    No rocking.

  2. 2.

    Barely noticeable rocking. Walking is normal.

  3. 3.

    Mild intermittent rocking that can be easily ignored. Walking is normal.

  4. 4.

    Mild persistent rocking, which is distracting.

  5. 5.

    Moderate intermittent rocking which requires extra attention to balance control. Walking is normal.

  6. 6.

    Moderate persistent rocking that leads to balance difficulty. May occasionally stumble.

  7. 7.

    Moderately severe, but intermittent rocking that impairs walking. Need occasional assistance to walk.

  8. 8.

    Moderately severe persistent rocking that leads to great balance difficulty. Need assistance to walk for greater distances or specific situations.

  9. 9.

    Severe rocking causing great difficulty with walking. Need constant gait assistance.

  10. 10.

    Severe rocking that prevents any walking.

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Riley, J., Gleghorn, D., Doudican, B.C. et al. Psychological assessment of individuals with Mal de Débarquement Syndrome. J Neurol (2021). https://doi.org/10.1007/s00415-021-10767-4

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Keywords

  • Mal de Débarquement Syndrome
  • Persistent oscillating vertigo
  • Psychological profile
  • Vestibular disorder