Dizziness, migrainous vertigo and psychiatric disorders
Abstract
Objectives: This study sought to establish the prevalence of vestibular disorders, migraine and definite migrainous vertigo in patients with psychiatric disorders who were referred for treatment of dizziness, without a lifetime history of vertigo. Study design: Retrospective study. Setting: Out-patients in a university hospital. Materials and methods: Fifty-two dizzy patients with panic disorders and agoraphobia, 30 with panic disorders without agoraphobia, and 20 with depressive disorders underwent otoneurological screening with bithermal caloric stimulation. The prevalence of migraine and migrainous vertigo was assessed. The level of dizziness was evaluated using the Dizziness Handicap Inventory. Results: Dizzy patients with panic disorders and agoraphobia had a significantly p = 0.05 regarding the prevalence of peripheral vestibular abnormalities in the group of subjects with PD and agoraphobia and in those with depressive disorders. Migraine was equally represented in the three groups, but panic disorder patients had a higher prevalence of migrainous vertigo definite migrainous vertigo. Almost all patients with a peripheral vestibular disorder had a final diagnosis of definite migrainous vertigo according to Neuhauser criteria. These patients had higher Dizziness Handicap Inventory scores. The Dizziness Handicap Inventory total score was higher in the subgroup of patients with panic disorders with agoraphobia also presenting unilateral reduced caloric responses or definite migrainous vertigo, compared with the subgroup of remaining subjects with panic disorders with agoraphobia (p < 0.001). Conclusions: Our data support the hypothesis that, in patients with panic disorders (and especially those with additional agoraphobia), dizziness may be linked to malfunction of the vestibular system. However, the data are not inconsistent with the hypothesis that migrainous vertigo is the most common pathophysiological mechanism for vestibular disorders.
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Some experimental studies have found subclinical abnormalities in balance systems and postural instability particularly related to impaired visuovestibular interactions in panic disorder patients; this feature is thought to influence the development and course of agoraphobia.
“Some experimental studies have found subclinical abnormalities in these patients’ balance systems and postural instability particularly related to impaired visuovestibular interactions; this feature is thought to influence the development and course of agoraphobia [60–64].”
From Management of Treatment-Resistant Panic Disorder (2017) · cites this paper as [62]
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- Authors
- Teggi, R., Caldirola, D., Colombo, B., Perna, G., Comi, G., Bellodi, L., & Bussi, M.
- Affiliations
- Vita-Salute San Raffaele University (IT)
- Corresponding author
- Teggi, R
- Venue
- The Journal of Laryngology & Otology
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-12-03
- Volume
- 124
- Issue
- 3
- Pages
- 285-290
- ISSN
- 0022-2151 (ISSN-L)
- 1748-5460
- OpenAlex
- W1992473712
- Cited by
- 34
- References
- 44
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 6 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 2 · 2013: 2 · 2012: 1
- FWCI
- 1.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Laryngology & Otology (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- dizziness, vestibular migraine, migraine, mental illness, panic disorder, agoraphobia, depressive disorders, peripheral vestibular disorders, Dizziness Handicap Inventory, vestibular dysfunction
- MeSH terms
- Adult, Anxiety Disorders, Caloric Tests, Depressive Disorder, Dizziness, Female, Humans, Male, Middle Aged, Migraine Disorders, Nystagmus, Physiologic, Retrospective Studies, Saccades, Severity of Illness Index, Vertigo, Prevalence, Chi-Square Distribution
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