Psychiatric disorders and functional impairment in patients with persistent dizziness

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Abstract
Objective: To determine the prevalence and predictors of psychiatric dizziness and to measure functional impairment associated with dizziness. Design: Consecutive outpatients with a chief complaint of dizziness. Setting: Four outpatient clinics at a military teaching hospital. Patients: 100 dizzy patients and 25 control patients. Measurements and main results: Structured psychiatric interviews were conducted using the Diagnostic Interview Schedule, and functional status was assessed with the Sickness Impact Profile and the 20-item MOS (Medical Outcomes Study) Short-Form. Psychiatric disorders were a primary or contributory cause of dizziness for 40% of the dizzy patients. Compared with the control patients, the dizzy patients had a higher lifetime (46% vs 32%) as well as recent (37% vs 20%) prevalence of axis I disorders. The greatest differences were in disorders of depression and somatization. The dizzy patients had a higher lifetime prevalence (2 3% vs 8%) as well as recent history (11 % vs 0%) of major depression or dysthymia. Also, somatization disorders were strikingly more common among the dizzy patients than among the control patients (37% vs 8%, p=0.005), with the dizzy patients reporting more than three times as many psychiatric or unexplained physical symptoms (5.2 vs 1.5). Age Conclusions: Persistent dizziness is associated with increased functional impairment and psychiatric comorbidity, particularly depression and somatization. Moreover, psychiatric disorders aggravate the impairment that occurs with dizziness alone.