Abstract
The sensation of vertigo, a subjective complaint, is sometimes defined as a hallucination of movement or an illusion. Since evaluation of hallucinations and illusions is an essential part of psychiatric practice, such definitions place vertigo at the doorstep of clinical psychiatry (Trimble 1984). Vertigo is a frequent symptom of psychiatric illness, in particular in anxiety, depression, and personahty disorders, but less frequent in psychosis. However, to complicate matters, because of its incapacitating nature vestibular dysfunction frequently causes psychiatric illness. This may bias the diagnosis of organic vertigo syndromes by a considerable neurotic overlay e.g. in patients with Menière’s disease. Alternatively, a transient labyrinthine dysfunction, e.g. in vestibular neuritis, may initiate development of neurosis in which anxiety, panic attacks and depression are most common, and which typically preserves subjective vertigo and postural imbalance although the peripheral lesion is already either recovered or centrally compensated. In the latter case there is a history of an initial rotational vertigo, lateropulsion and nausea (with the objective clinical signs of horizontal rotatory nystagmus and unilateral hyporesponsiveness to caloric irrigation) which is followed by a more indefinite chronic dizziness with subjective postural imbalance or spells of vertigo during active body movements, associated with anxiety and change in behaviour (see Phobic Postural Vertigo, p. 292). Obsessional subjects are more likely to proceed from organic to psychiatric disease, and the obvious presence of an obsessional personality will support the diagnosis of this condition.
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References
Agras WS, Chapin HN, Oliveau DC (1972) The natural history of phobia. Arch Gen Psychiat 26:315–317
Aronson TA (1987) Is panic disorder a distinct diagnostic entity? A critical review of the borders of a syndrome. J Nerv Ment Disease 175:584–594
Baker BL, Cohen DC, Saunders JT (1973) Self-directed desensitization for acrophobia. Behav Res Ther 11:79–89
Brandt Th (1984) Visual vertigo and acrophobia. In: Dix MR, Hood ID (eds) Vertigo. John Wiley & Sons, Chichester, New York, pp 439–466
Brandt Th (1990) Vertigo -a systematic approach. In: Kennard C (ed) Recent advances in chnical neurology. Churchill Livingstone, Edinburgh, London, pp 59–84
Brandt Th, Daroff RB (1980) The multisensory physiological and pathological vertigo syndromes. Ann Neurol 7:195–203
Brandt Th, Dieterich M (1986) Phobischer Attacken-Schwankschwindel. Münch Med Wschr 128:247–250
Cohen DC (1977) Comparison of self-report and overt-behavioral procedures for assessing acrophobia. Behav Ther 8:17–23
Crowe RR, Noyes R, Pauls DL, Slymen D (1983) A family study of panic disorder. Arch Gen Psychiat 40:1065–1069
Curlee J, Stern H (1973) The fear of heights among alcoholics. Bull. Menninger Clin 37:615–623
De Paulo JR, Folstein MF (1978) Psychiatric disturbances in neurological patients. Ann Neurol 4:225–228
Fitzgerald G, Stengel E (1945) Vestibular reactivity to caloric stimulation in schizophrenics. J Ment Sci 91:93–100
Freud S (1898) Gesammelte Werke in Einzelbänden. Vol 1, Werke aus den Jahren 1892–1899 Fischer, Frankfurt
Goethe JW v (1771) In: Selbstbiographische Schriften, Dichtung und Wahrheit. 9. Buch der Straßburger Tischgesellschaft, Selbsterziehung
Guralnick MJ (1973) Behaviour therapy with an acrophobic mentally retarded young adult. J Behav Ther Exp Psychol 4:263–265
Hallpike CS, Spencer Harrison M, Slater E (1951) Abnormalities of the caloric test results in certain varieties of mental disorder. Acta Otolaryngol 39:151–159
Harris EL, Noyes R, Crowe RR, Chaudhry DR (1983) Family study of agoraphobia. Arch Gen Psychiat 40:1061–1064
Hinchcliffe R (1967) Personality profile in Menière’s disease. J Laryngol Otolaryngol 81:476–481
Hoist E v., Mittelstaedt H (1950) Das Reafferenzprinzip (Wechselwirkungen zwischen Zentralnervensystem und Peripherie). Naturwissenschaften 37:464–476
Jacob RG, Møller MB, Turner SM, Wall III C (1985) Otoneurological examination in panic disorder and agoraphobia with panic attacks: a pilot study. Amer J Psychiat 142:715–720
Kirk C, Saunders M (1977) Primary psychiatric illness in a neurological outpatient department in North-East England. Acta Psychiat Scand 56:294–302
Knights EB, Folstein MF (1977) Unsuspected emotional and cognitive disturbance in medical patients. Ann Intern Med 89:723–724
Lempert Th, Dieterich M, Huppert D, Brandt Th (1990) Psychogenic disorders in neurology: frequency and clinical spectrum. J Neurol Neurosurg Psychiat (in press)
Lipowski ZJ (1967) Review of consultation. Psychiatry and psychosomatic medicine. II. Clinical aspects. Psychosom Med 29:201–244
Marks IM (1970) The classification of phobic disorders. Brit J Psychiat 116:337–386
Marks IM (1981) Space “phobia”: a pseudo-agoraphobic syndrome. J Neurol Neurosurg Psychiat 44:387–391
Mavissakahan M (1988) The placebo effect in agoraphobia: II. J Nerv Ment Dis 176:446–448
Meilstrom M, Cicala GA, Zuckermann M (1976) General versus specific trait anxiety measures in the prediction of fear of snakes, heights and darkness. J Consult Clin Psychol 44:83–91
Merskey H, Buhrich NA (1975) Hysteria and organic brain disease. Brit J Med Psychol 48:359–376
Mirabile CS, Glueck BC, Stroebel CF, Pitblado C (1977) Susceptibility to motion sickness and ego closeness-ego distance as measured by the autokinetic response tendency. Neuropsychobiol 3:193–198
Mirabile CS, Glueck BC (1980) Motion sickness susceptibilty and patterns of psychotic illness. Arch Gen Psychiat 37:42–50
Noyes R, Clancy J, Hoenk PR, Hymen DJ (1980) The prognosis of anxiety neurosis. Arch Gen Psychiat 37:173–178
Peck CL (1977) Desensitization for the treatment of fear in the high level adult retardate. Behav Res Ther 15:137–148
Pogany E (1958) Über den Höhenschwindel. Mschr Ohrenheilk Laryng-Rhinol 92:209–213
Pratt RTC, McKenzie W (1958) Anxiety states following vestibular disorders. Lancet 11:347–349
Ritter B (1969a) Treatment of acrophobia with contact desensitization. Behav Res Ther 7:41–45
Ritter B (1969b) The use of contact desensitization, demonstration-plus-participation and demonstration-alone in the treatment of acrophobia. Behav Res Ther 7:157–164
Schilder P (1933) The vestibular apparatus in neurosis and psychosis. J Nerv Ment Dis 78:1–23, 137–164
Sheehan DV, Ballenger J, Jacobsen G (1980) Treatment of endogenuous anxiety with phobic, hysterical and hypochondriacal symptoms. Arch Gen Psychiat 37:51–59
Shevitz SA, Silberfarb PM, Lipowski ZJ (1976) Psychiatric consultations in a general hospital. A report on 1000 referrals. Dis Nerv Syst 37:259–300
Singerman B, Riedner E, Folstein M (1980) Emotional disturbance in hearing clinic patients. Brit J Psychiat 137:58–62
Takeya T, Baron JB, Ohno Y, Agathon M, Andersson JC, Ushio N, Bessineton JC, Pacifici M, Lemaire V, Chavannes N, Noto R (1978) Comparative study of post-traumatic and psychogenic acrophobia (fear of height). Agressologie 19:19–92
Takeya T, Ohno Y, Matsubara H, Yasuda K, Watanabe S, Shinzato R, Tanaka Y, Nöda S (1979) Physiological changes in the treatment of acrophobia (fear of height). Clin Otolaryngol 4:197–205
Trimble MR (1984) Psychiatric aspects of vertigo. In: Dix MR, Hood DD (eds) Vertigo. John Wiley & Sons, Chichester, New York, pp 345–358
Whitlock FA (1967) The aetiology of schizophrenia. Acta Psychiat Scand 43:144–162
Williams D (1975) The borderland of epilepsy revisited. Brain 98:1–12
Wölpe J (1958) Psychotherapy by reciprocal inhibition. Stanford University Press, Stanford
Zitrin CM, Klein DF, Woerner MG (1980) Treatment of acrophobia with group exposure in vivo and imipramine. Arch Gen Psychiat 37:63–72
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Brandt, T. (1991). Psychogenic Vertigo. In: Vertigo: Its Multisensory Syndromes. Clinical Medicine and the Nervous System. Springer, London. https://doi.org/10.1007/978-1-4471-3342-1_24
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DOI: https://doi.org/10.1007/978-1-4471-3342-1_24
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