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Effects of treatment on anxiety levels among patients with benign paroxysmal positional vertigo

  • Akif GunesEmail author
  • Yucel Yuzbasioglu
Otology
  • 45 Downloads

Abstract

Purpose

The association of vertigo with anxiety disorders is well known. Herein, we aimed to determine the relationship between pre-treatment and post-treatment anxiety levels, assessed with Beck anxiety inventory, with educational status among patients diagnosed with and treated for Benign paroxysmal positional vertigo (BPPV), and to evaluate the effect of treatment on the sub-parameters of the Beck anxiety inventory.

Methods

Our study included a total of 33 patients that presented to the otorhinolaryngology outpatient clinic with acute vertigo and were diagnosed to have posterior canal BPPV. Patients diagnosed with posterior BPPV were applied Beck anxiety inventory prior to the treatment as well as 1 week and 4 weeks after the treatment.

Results

Compared to the control group, statistically significant changes were observed in relation to pre-treatment and post-treatment inventory scores (p < 0.05). A comparison of the pre-treatment and post-treatment assessments revealed significant differences (p < 0.05). Improvements were observed in 48% (10/21) of the subparameters by the end of the first week at the earliest. Educational status had no significant effect on inventory scores (p > 0.05).

Conclusion

Anxiety-related subjective symptoms mostly started to improve 1 week after the treatment at the earliest, and symptoms showed persistence at a certain level even at the end of the first month. Inequalities between the patients’ educational levels affect anxiety levels. It should be remembered that educational status should be considered when approaching patients.

Keywords

Anxiety Beck anxiety inventory Vertigo Benign paroxysmal positional vertigo BPPV 

Notes

Funding

No financial support was received for this paper.

Compliance with ethical standards

Conflict of interest

Akif Gunes declares that he has no conflict of interest. Yucel Yuzbasioglu declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Cohen HS (2006) Disability and rehabilitation in the dizzy patient. Curr Opin Neurol 19(1):49–54.  https://doi.org/10.1097/01.wco.0000194373.08203.33 Google Scholar
  2. 2.
    Akkuzu G, Akkuzu B, Ozluoglu LN (2006) Vestibular evoked myogenic potentials in benign paroxysmal positional vertigo and Meniere’s disease. Eur Arch Oto-Rhino-Laryngol Head Neck 263(6):510–517.  https://doi.org/10.1007/s00405-005-0002-x Google Scholar
  3. 3.
    Tang H, Li W (2017) Advances in the diagnosis and treatment of benign paroxysmal positional vertigo. Exp Ther Med 14(3):2424–2430.  https://doi.org/10.3892/etm.2017.4837 PubMedCentralGoogle Scholar
  4. 4.
    Kozak HH, Dundar MA, Uca AU et al (2018) Anxiety, mood, and personality disorders in patients with benign paroxysmal positional vertigo. Noro Psikiyatr 55(1):49–53.  https://doi.org/10.5152/npa.2016.18143 Google Scholar
  5. 5.
    Lee S-H, Kim JS (2010) Benign paroxysmal positional vertigo. J Clin Neurol 6(2):51–63.  https://doi.org/10.3988/jcn.2010.6.2.51 PubMedCentralGoogle Scholar
  6. 6.
    Baloh R, Halmagyi M (1996) Handbook of neuro-otology/vestibular system, New YorkGoogle Scholar
  7. 7.
    Magliulo G, Bertin S, Ruggieri M, Gagliardi M (2005) Benign paroxysmal positional vertigo and post-treatment quality of life. Eur Arch Otorhinolaryngol 262(8):627–630.  https://doi.org/10.1007/s00405-004-0784-2 Google Scholar
  8. 8.
    Katsarkas A (1999) Benign paroxysmal positional vertigo (BPPV): idiopathic versus post-traumatic. Acta Otolaryngol 119(7):745–749Google Scholar
  9. 9.
    Gordon CR, Levite R, Joffe V, Gadoth N (2004) Is posttraumatic benign paroxysmal positional vertigo different from the idiopathic form? Arch Neurol 61(10):1590–1593.  https://doi.org/10.1001/archneur.61.10.1590 Google Scholar
  10. 10.
    Asmundson GJ, Larsen DK, Stein MB (1998) Panic disorder and vestibular disturbance: an overview of empirical findings and clinical implications. J Psychosom Res 44(1):107–120Google Scholar
  11. 11.
    Staab JP (2006) Chronic dizziness: the interface between psychiatry and neuro-otology. Curr Opin Neurol 19(1):41–48.  https://doi.org/10.1097/01.wco.0000198102.95294.1f Google Scholar
  12. 12.
    Sklare DA, Konrad HR, Maser JD, Jacob RG (2001) Special issue on the interface of balance disorders and anxiety: an introduction and overview. J Anxiety Disord 15(1–2):1–7.  https://doi.org/10.1016/S0887-6185(00)00039-6 Google Scholar
  13. 13.
    Balaban CD, Thayer JF (2001) Neurological bases for balance–anxiety links. J Anxiety Disord 15(1–2):53–79.  https://doi.org/10.1016/S0887-6185(00)00042-6 Google Scholar
  14. 14.
    Yardley L, Medina S, Jurado C, Morales T, Martinez R, Villegas H (1999) Relationship between physical and psychosocial dysfunction in Mexican patients with vertigo: a cross-cultural validation of the vertigo symptom scale. J Psychosom Res 46(1):63–74.  https://doi.org/10.1016/S0022-3999(98)00056-7 Google Scholar
  15. 15.
    Reale L, Guarnera M, Grillo C, Maiolino L, Ruta L, Mazzone L (2011) Psychological assessment in children and adolescents with benign paroxysmal vertigo. Brain Dev 33(2):125–130.  https://doi.org/10.1016/j.braindev.2010.03.006 Google Scholar
  16. 16.
    Pollak L, Segal P, Stryjer R, Stern HG (2012) Beliefs and emotional reactions in patients with benign paroxysmal positional vertigo: a longitudinal study. Am J Otolaryngol 33(2):221–225.  https://doi.org/10.1016/j.amjoto.2011.07.002 Google Scholar
  17. 17.
    Clark MR, Sullivan MD, Katon WJ et al (1993) Psychiatric and medical factors associated with disability in patients with dizziness. Psychosomatics 34(5):409–415.  https://doi.org/10.1016/S0033-3182(93)71844-7 Google Scholar
  18. 18.
    Kirby SE, Yardley L (2009) The contribution of symptoms of posttraumatic stress disorder, health anxiety and intolerance of uncertainty to distress in Ménière’s disease. J Nerv Mental Dis 197(5):324–329.  https://doi.org/10.1097/NMD.0b013e3181a20866 Google Scholar
  19. 19.
    Godemann F, Linden M, Neu P, Heipp E, Dörr P (2004) A prospective study on the course of anxiety after vestibular neuronitis. J Psychosom Res 56(3):351–354.  https://doi.org/10.1016/S0022-3999(03)00079-5 Google Scholar
  20. 20.
    Steer RA, Ranieri WF, Beck AT, Clark DA (1993) Further evidence for the validity of the Beck anxiety inventory with psychiatric outpatients. J Anxiety Disord 7(3):195–205.  https://doi.org/10.1016/0887-6185(93)90002-3 Google Scholar
  21. 21.
    Kahraman SS, Arli C, Copoglu US, Kokacya MH, Colak S (2017) The evaluation of anxiety and panic agarophobia scores in patients with benign paroxysmal positional vertigo on initial presentation and at the follow-up visit. Acta Otolaryngol 137(5):485–489.  https://doi.org/10.1080/00016489.2016.1247986 Google Scholar
  22. 22.
    Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consul Clin Psychol 56(6):893–897.  https://doi.org/10.1037/0022-006X.56.6.893 Google Scholar
  23. 23.
    Eagger S, Luxon L, Davies R, Coelho A, Ron M (1992) Psychiatric morbidity in patients with peripheral vestibular disorder: a clinical and neuro-otological study. J Neurol Neurosurg Psychiatry 55(5):383–387.  https://doi.org/10.1136/jnnp.55.5.383 PubMedCentralGoogle Scholar
  24. 24.
    Mckenna L, Hallam RS, Hinchcliffef R (1991) The prevalence of psychological disturbance in neuro-otology outpatients. Clin Otolaryngol Allied Sci 16(5):452–456.  https://doi.org/10.1111/j.1365-2273.1991.tb02091.x Google Scholar
  25. 25.
    Clark DB, Hirsch BE, Smith MG, Furman J, Jacob RG (1994) Panic in otolaryngology patients presenting with dizziness or hearing loss. Am J Psychiatry 151(8):1223.  https://doi.org/10.1176/ajp.151.8.1223 Google Scholar
  26. 26.
    Best C, Eckhardt-Henn A, Tschan R, Dieterich M (2009) Psychiatric morbidity and comorbidity in different vestibular vertigo syndromes. J Neurol 256(1):58–65.  https://doi.org/10.1007/s00415-009-0038-8 Google Scholar
  27. 27.
    Best C, Eckhardt-Henn A, Diener G, Bense S, Breuer P, Dieterich M (2006) Interaction of somatoform and vestibular disorders. J Neurol Neurosurg Psychiatry 77(5):658–664.  https://doi.org/10.1136/jnnp.2005.072934 PubMedCentralGoogle Scholar
  28. 28.
    Yardley L (2000) Overview of psychologic effects of chronic dizziness and balance disorders. Otolaryngol Clin North Am 33(3):603–616.  https://doi.org/10.1016/S0030-6665(05)70229-2 Google Scholar
  29. 29.
    Jung HJ, Koo J-W, Kim CS, Kim JS, Song J-J (2012) Anxiolytics reduce residual dizziness after successful canalith repositioning maneuvers in benign paroxysmal positional vertigo. Acta Otolaryngol 132(3):277–284.  https://doi.org/10.3109/00016489.2011.637179 Google Scholar
  30. 30.
    Yardley L (1994) Contribution of symptoms and beliefs to handicap in people with vertigo: a longitudinal study. Br J Clin Psychol 33(1):101–113Google Scholar
  31. 31.
    Jacob RG, Lilienfeld SO, Furman JM, Durrant JD, Turner SM (1989) Panic disorder with vestibular dysfunction: further clinical observations and description of space and motion phobic stimuli. J Anxiety Disord 3(2):117–130Google Scholar
  32. 32.
    Yardley L, Verschuur C, Masson E, Luxon L, Haacke N (1992) Somatic and psychological factors contributing to handicap in people with vertigo. Br J Audiol 26(5):283–290Google Scholar
  33. 33.
    Yardley L, Luxon L, Haacke N (1994) A longitudinal study of symptoms, anxiety and subjective well-being in patients with vertigo. Clin Otolaryngol Allied Sci 19(2):109–116.  https://doi.org/10.1111/j.1365-2273.1994.tb01192.x Google Scholar
  34. 34.
    Fielder H, Denholm S, Lyons R, Fielder C (1996) Measurement of health status in patients with vertigo. Clin Otolaryngol Allied Sci 21(2):124–126.  https://doi.org/10.1111/j.1365-2273.1996.tb01314.x Google Scholar
  35. 35.
    Eckhardt-Henn A, Breuer P, Thomalske C, Hoffmann S, Hopf H (2003) Anxiety disorders and other psychiatric subgroups in patients complaining of dizziness. J Anxiety Disord 17(4):369–388.  https://doi.org/10.1016/S0887-6185(02)00226-8 Google Scholar
  36. 36.
    Staab JP, Ruckenstein MJ (2003) Which comes first? Psychogenic dizziness versus otogenic anxiety. Laryngoscope 113(10):1714–1718.  https://doi.org/10.1097/00005537-200310000-00010 Google Scholar
  37. 37.
    Nagarkar AN, Gupta AK, Mann SBS (2000) Psychological findings in benign paroxysmal positional vertigo and psychogenic vertigo. J Otolaryngol 29(3):154–158Google Scholar
  38. 38.
    Monzani D, Genovese E, Rovatti V, LudovicaMalagoli M, Rigatelli M, Guidetti G (2006) Life events and benign paroxysmal positional vertigo: a case-controlled study. Acta Otolaryngol 126(9):987–992.  https://doi.org/10.1080/00016480500546383 Google Scholar
  39. 39.
    Yardley L, Burgneay J, Nazareth I, Luxon L (1998) Neuro-otological and psychiatric abnormalities in a community sample of people with dizziness: a blind, controlled investigation. J Neurol Neurosurg Psychiatry 65(5):679–684.  https://doi.org/10.1136/jnnp.65.5.679 PubMedCentralGoogle Scholar
  40. 40.
    Sullivan M, Clark MR, Katon WJ et al (1993) Psychiatric and otologic diagnoses in patients complaining of dizziness. Arch Intern Med 153(12):1479–1484.  https://doi.org/10.1001/archinte.1993.00410120059008 Google Scholar
  41. 41.
    Wiltink J, Tschan R, Michal M et al (2009) Dizziness: anxiety, health care utilization and health behavior: results from a representative German community survey. J Psychosom Res 66(5):417–424.  https://doi.org/10.1016/j.jpsychores.2008.09.012 Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of OtorhinolaryngologyEskişehir City HospitalEskişehirTurkey
  2. 2.Department of Emergency MedicineKeçiören Education and Research HospitalAnkaraTurkey

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