Clinical Research Unit for Anxiety and Depression, University of New South Wales at St Vincent's Hospital, Darlinghurst, NSW, Australia.
Am J Otolaryngol. 2012 Jul-Aug;33(4):395-401. doi: 10.1016/j.amjoto.2011.10.009. Epub 2011 Nov 21.
The aim of this study was to evaluate the effects of a brief cognitive behavior therapy (CBT) intervention on the physical symptoms, illness-related disability, and psychologic distress of patients with chronic subjective dizziness.
Forty-one patients with chronic subjective dizziness referred by a neurootologic clinic were randomly assigned to immediate treatment or a wait-list control. Three weekly treatment sessions based on the CBT model of panic disorder, adapted for patients with dizziness, were administered by a clinical psychologist. Treatment included psychoeducation, behavioral experiments, exposure to feared stimuli, and attentional refocusing. Outcomes were measured on the Dizziness Handicap Inventory and the Depression, Anxiety and Stress Scales. Two further measures developed for this study; the Dizziness Symptoms Inventory and the Safety Behaviours Inventory were used to measure physical symptoms and safety behaviors.
The intervention was associated with significant reductions in disability on the Dizziness Handicap Inventory, reduced dizziness and related physical symptoms on the Dizziness Symptoms Inventory, and reduced avoidance and safety behaviors as measured by the Safety Behaviours Inventory. Pre- to posteffect sizes ranged from 0.98 to 1.15. There was no change in psychologic outcomes measured on the Depression, Anxiety and Stress Scales.
A 3-session psychologic intervention based on the CBT model can produce significant improvements in dizziness-related symptoms, disability, and functional impairment among patients with chronic subjective dizziness. This suggests that treatment of this condition may be reasonably simple and cost-effective for most of the patients.
本研究旨在评估短期认知行为疗法（CBT）干预对慢性主观性头晕患者的躯体症状、与疾病相关的残疾和心理困扰的影响。
41 名因神经耳科就诊而被转诊的慢性主观性头晕患者被随机分配到立即治疗或等待名单对照。由临床心理学家进行基于惊恐障碍 CBT 模型的 3 次每周治疗，该模型适用于头晕患者。治疗包括心理教育、行为实验、暴露于恐惧刺激物和注意力重定向。采用头晕障碍量表（Dizziness Handicap Inventory）和抑郁、焦虑和压力量表（Depression, Anxiety and Stress Scales）来评估结局。本研究还使用了另外两个量表：头晕症状量表（Dizziness Symptoms Inventory）和安全行为量表（Safety Behaviours Inventory）来测量躯体症状和安全行为。
干预与头晕障碍量表上残疾程度的显著降低、头晕症状量表上头晕和相关躯体症状的减少以及安全行为量表上回避和安全行为的减少相关。预治疗到治疗后效应大小范围为 0.98 至 1.15。抑郁、焦虑和压力量表上的心理结局没有变化。
基于 CBT 模型的 3 次心理干预可显著改善慢性主观性头晕患者的头晕相关症状、残疾和功能障碍。这表明，对于大多数患者来说，这种疾病的治疗可能是合理简单且具有成本效益的。
