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a Department of Psychology, University College London,
Gower St, London, UK, b Hearing and Balance
Centre, Institute of Sound and Vibration Research, University of
Southampton, Highfield, Southampton, UK, c Department of Primary Care and Population Sciences, Royal Free
Hospital School of Medicine and University College London Medical
School, Royal Free Hospital School of Medicine, Rowland Hill St,
London, UK, d Institute of
Laryngology and Otology, University College London, 330/332 Gray's Inn
Road, London, UK
Correspondence to: Dr L Yardley, Department of Psychology, University College London, Gower St, London WC1E 6BT, UK.
Received 27 November 1998 and in revised form 12 March 1998;
Accepted 16 April 1998
OBJECTIVES
To determine neuro-otological and
psychiatric abnormalities associated with complaints of dizziness in an
epidemiological community sample of people of working age, and the
extent of comorbidity between neuro-otological and psychiatric dysfunction.
METHODA survey of 3884 people randomly
selected from six general practice lists identified 262 people with
significant dizziness, from which a subsample of 15 men and 22 women
were recruited for testing. Dizzy subjects were evaluated by blind
neuro-otological testing, computerised dynamic posturography, a
computerised psychiatric assessment, neuro-otological and general
medical examination, and diagnosis. An age matched control group of
18 men and 22 women underwent the same evaluation.
RESULTSTests of auditory, vestibular, and
oculo-motor function did not discriminate between dizzy subjects and
controls, but dizzy subjects had significantly worse balance on
posturographic testing, more diagnoses of medical disorder, and a
higher prevalence of psychiatric morbidity.
CONCLUSIONSThe findings suggest that dizziness in
the community is typically characterised by mild physical disorder
accompanied by some psychiatric disturbance. As the combination of
minor physical and psychiatric disorder is known to be unusually
persistent and handicapping, treatment programmes must be provided for
this prevalent syndrome, perhaps by a partnership between primary care
and neuro-otological and psychiatric hospital outpatient clinics with
experience and expertise in the diagnosis and management of dizziness
and psychiatric disturbance.
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