A Psychosomatic Approach to Patients with Vertigo

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A clinical survey was performed to evaluate psychological factors in patients with vertigo or dizziness.Some patients with no positive neuro-otological findings in the ENT clinic were diagnosed as having primary neurosis or psychosis. Most of them suffered from anxiety neurosis. In these cases, there was associated palpitaion, shortness of breath, fatigue, and insomnia as well as some psychoneurotic symptoms.A detailed history and evaluation of mental status are recommended to detect these psychosomatic elements.Most of the patients with vertigo of organic origin showed tension and anxiety. The interview with them revealed that this anxiety was a reaction to the disabling symptom, and their lack of knowledge about their disease played an important role in the increase of anxiety.We otologists should attempt to allay the patient's anxiety. It should be noted that detailed historytaking has a cathartic effect. Explaining their diseases to them is also recommended to reduce anxiety.Patients with Meniere's disease, non-Meniere vertigenous disease of the peripheral type, and chronic otitis media were tested with the Maudsley Personality Inventory.Patients with Meniere's disease tended to have a significantly lower L-score than the other two groups, and a higher E-score than chronic otitis media patients. Further study is needed to determine whether these results are related to the sequence or to the etiology or to the disease itself.The psychotherapeutic approach to allay the patient's anxiety is effective in reducing the symptom's severity in vertigenous disease. Moreover, it may have some therapeutic effect on the course of the disease itself.
耳鼻咽喉科臨床学会の論文

A Psychosomatic Approach to Patients with Vertigo

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