Original ArticlesThe Longitudinal Effect of Vertigo and Dizziness Symptoms on Psychological Distress Symptom-Related Fears and Beliefs as MediatorsRadziej, Katharina Dipl.-Psych.*†; Probst, Thomas Dr. rer. nat.‡§; Limburg, Karina MSc*†; Dinkel, Andreas Dr. rer. nat.*; Dieterich, Marianne Univ. Prof. Dr. med.†∥; Lahmann, Claas Univ. Prof. Dr. med.¶Author Information *Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich; †German Centre for Vertigo and Balance Disorders, Klinikum Großhadern, Ludwig-Maximilians-Universitaet Muenchen, Munich; ‡Department of Clinical Psychology and Psychotherapy, Georg-August-Universitaet Goettingen, Goettingen, Germany; §Department of Psychotherapy and Bio-Psycho-Social Health, Danube University Krems, Krems, Austria; ∥Department of Neurology, Ludwig-Maximilians-Universitaet Muenchen, Munich; and ¶Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Ethical approval: The ethics committee of the Medical Department of the Ludwig-Maximilians-Universitaet, Munich, Germany, reviewed and approved this study (ref: 108–10). Send reprint requests to Katharina Radziej, Dipl.-Psych., Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Klinikum rechts der Isar, Technische Universität München, Langerstr. 3/I, D-81675 München, Germany. E-mail: firstname.lastname@example.org. The Journal of Nervous and Mental Disease: April 2018 - Volume 206 - Issue 4 - p 277-285 doi: 10.1097/NMD.0000000000000791 Buy Metrics Abstract Despite the frequent observation that vertigo and dizziness (VD) disorders may trigger or exacerbate secondary psychiatric comorbidities, there is limited understanding of the mechanisms underlying this development. To address this gap, we investigated whether symptom-related fears and cognitions as indicated by questionnaire-based measures are mediators of the longitudinal effect of VD symptoms on anxiety and depression after 1 year. We analyzed data from a large study with patients of a treatment center specialized in vertigo (N = 210). Simple and multiple parallel mediation models strengthened our hypothesis that fear of bodily sensations and cognitions about these symptoms play a mediating role in the relationship between VD symptoms and psychopathology at follow-up after baseline scores of the outcome were controlled for. Results are discussed within a cognitive theory framework and point to the potential benefits of interventions that modify symptom-related beliefs and fears via cognitive psychotherapy in this therapeutically underserved population. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.