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Persistence of Symptoms in Primary Somatoform Vertigo and Dizziness: A Disorder “Lost” in Health Care?

Tschan, Regine PhD*; Best, Christoph MD; Wiltink, Jörg MD*; Beutel, Manfred E. MD*; Dieterich, Marianne MD; Eckhardt-Henn, Annegret MD§

Journal of Nervous & Mental Disease: April 2013 - Volume 201 - Issue 4 - p 328–333
doi: 10.1097/NMD.0b013e318288e2ad
Original Articles

Abstract: The aim of this study was to perform a 3-year follow-up of primary somatoform vertigo and dizziness (SVD) regarding health care use and treatment. Ninety-two patients with dizziness underwent detailed vestibular neurophysiological testing and a Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Psychometric assessments comprised the Vertigo Symptom Scale, the Vertigo Handicap Questionnaire, the SCL-90-R, and the Short-Form–36 Health Survey. At the 3-year follow-up, 65 patients with primary SVD (anxiety, n = 29; depression, n = 14; somatoform disorders, n = 22) were reassessed (70.7% response). The patients improved in symptom severity (p < 0.05), handicap (p < 0.01), and physical quality of life (QoL; p < 0.05) but showed no change in emotional distress. A total of 63.1% (of n = 65) had ongoing SVD. A total of 69.2% (of n = 65) received different forms of treatments. A total of 46.1% (of n = 65) searched redundant medical diagnostic procedures. The patients with decreased coping capacity over time obtained the best prognosis. Primary SVD is an ineffectively treated disorder. Recommendations for specific complaint-oriented psychotherapy programs were given.

*Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; †Department of Neurology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; ‡Department of Neurology, Ludwig-Maximilians-University, Munich, Germany; and §Department of Psychosomatic Medicine, Bürgerhospital, Stuttgart, Germany.

Send reprint requests to Regine Tschan, PhD, Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany. E-mail: regine.tschan@unimedizin-mainz.de.

© 2013 Lippincott Williams & Wilkins, Inc.