OVERVIEW OF PSYCHOLOGIC EFFECTS OF CHRONIC DIZZINESS AND BALANCE DISORDERS
Section snippets
COMORBIDITY BETWEEN PSYCHOLOGIC DISTURBANCE AND DIZZINESS
Psychologic disturbance is more common among patients with balance disorder than in patients with many other disorders. In a study of neuro-otological outpatients,10 64% of dizzy patients were judged in need of psychological help, compared with only 27% of patients with hearing loss. Similarly, a study of dizzy patients attending an otolaryngology clinic3 found that 20% met the criteria for diagnosis of panic disorder, and a further one in four had symptoms of panic, whereas no patients with
Panic and Agoraphobia
Signs of psychologic disturbance can be manifested as physical symptoms, disturbing thoughts or cognitions, or maladaptive behavior (Table 1). For example, physical symptoms of panic that commonly accompany attacks of dizziness include signs of heightened autonomic arousal, such as racing heart, gasping for breath, feeling faint, and the belief that these physiologic changes signal danger, either from physical harm caused by passing out or falling over, or the social embarrassment caused by
Assessment
Despite the prevalence of psychologic disturbance in dizzy patients, routine medical examination seldom includes formal assessment of the psychologic aspects of their complaint. This may be because physicians consider the psychologic aspects to be the province of psychiatrists, to whom they may refer the patient if no organic pathology is diagnosed and psychogenic disturbance is suspected. But surprisingly few patients with suspected psychogenic disturbance are actually referred for psychiatric
SUMMARY
By the time people afflicted with dizziness or imbalance come to see a physician, many appear overanxious, even if they were previously confident, competent individuals. The purpose of this article has been to explain why dizziness so often leads to apprehensive, self-defeating thinking and behavior, which in turn perpetuates the dizziness. The state of fearful uncertainty and passive dependence in which many dizzy people find themselves trapped can be prevented in many cases by supplying
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Address reprint requests to Lucy Yardley, MSc, PhD, Department of Psychology, University of Southampton, Highfield, Southampton SO17 1BJ, United Kingdom
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Department of Psychology, University of Southampton, Southampton, United Kingdom