Neuro-otological and psychiatric abnormalities in a community sample of people with dizziness: a blind, controlled investigation

摘要

Objectives—To determine neurootologicaland psychiatric abnormalitiesassociated with complaints of dizziness inan epidemiological community sample ofpeople of working age, and the extent ofcomorbidity between neuro-otologicaland psychiatric dysfunction.Method—Asurvey of 3884 people randomlyselected from six general practice listsidentified 262 people with significant dizziness,from which a subsample of 15 menand 22 women were recruited for testing.Dizzy subjects were evaluated by blindneuro-otological testing, computerised dynamicposturography, a computerised psychiatricassessment, neuro-otological andgeneral medical examination, and diagnosis.An age matched control group of 18men and 22 women underwent the sameevaluation.Results—Tests of auditory, vestibular, andoculo-motor function did not discriminatebetween dizzy subjects and controls, butdizzy subjects had significantly worse balanceon posturographic testing,more diagnosesof medical disorder, and a higherprevalence of psychiatric morbidity.Conclusions—The findings suggest thatdizziness in the community is typicallycharacterised by mild physical disorderaccompanied by some psychiatric disturbance.As the combination of minorphysical and psychiatric disorder is knownto be unusually persistent and handicapping,treatment programmes must beprovided for this prevalent syndrome,perhaps by a partnership between primarycare and neuro-otological and psychiatrichospital outpatient clinics withexperience and expertise in the diagnosisand management of dizziness and psychiatricdisturbance.