长期残疾津贴或法律索赔可能会阻碍慢性头晕的康复。

Receiving Long-Term Disability or Pursuing a Legal Claim May Prevent Recovery From Chronic Dizziness.

机构信息

Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction & Mental Health, Toronto, Ontario, Canada.

Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.

出版信息

Laryngoscope. 2022 Mar;132(3):655-661. doi: 10.1002/lary.29871. Epub 2021 Sep 30.

DOI:10.1002/lary.29871

PMID:34591978

Abstract

OBJECTIVES/HYPOTHESIS: Chronic dizziness (CD) and imbalance have multiple etiologies. CD is strongly linked with psychiatric and psychological comorbidities, thus an interdisciplinary approach, including psychopharmacological interventions, is recommended. Despite the use of this comprehensive treatment approach, the recovery of individuals with CD that pursue long-term disability (LTD) insurance or legal claims (LC) appears hampered. As such, we aimed to compare symptom recovery from CD in an interdisciplinary setting between patients receiving LTD/LC versus those who were not, and to explore the factors that may contribute to changes in symptom severity.

STUDY DESIGN

Retrospective cohort study.

METHODS

Dizziness-related diagnoses were extracted from the charts of 195 adults in an outpatient interdisciplinary neurotology clinic in Toronto, Canada. Patients with baseline Dizziness Handicap Inventory (DHI) and Dizziness Catastrophizing Scale (DCS) assessments between August 2012 and July 2018 and a mean follow-up visit within approximately 10 months were included. The study participants were categorized as "LTD/LC+" (n = 92) or "LTD/LC-" (n = 103), referring to either receiving or pursuing LTD/LC or not, respectively.

RESULTS

There were differences in the mean percentage changes in DHI (t[187] = 3.02, P = .003) and DCS (t[179] = 2.63, P = .009) scores between LTD/LC+ and LTD/LC- patients. LTD/LC+ patients showed 8.0% and 7.6% mean increases in DHI and DCS scores, respectively, whereas LTD/LC- patients showed 21.5% and 25.9% reductions in DHI and DCS scores, respectively, controlling for age, sex, and baseline illness severity.

CONCLUSIONS

Patients receiving or pursuing LTD insurance or a legal claim did not improve from CD and dizziness catastrophizing compared to those who were not. Future studies are required to test these findings prospectively and to determine the factors that may contribute to symptom recovery, including the anxiety-aggravating effects of the LTD/LC process and the deleterious consequences of developing a sick-role while afflicted with a chronic illness.

LEVEL OF EVIDENCE

3 Laryngoscope, 132:655-661, 2022.

摘要

目的/假设：慢性头晕（CD）和平衡障碍有多种病因。CD 与精神和心理合并症密切相关，因此建议采用跨学科方法，包括精神药理学干预。尽管采用了这种全面的治疗方法，但长期残疾（LTD）保险或法律索赔（LC）的 CD 患者的康复似乎受到阻碍。因此，我们旨在比较接受 LTD/LC 与不接受 LTD/LC 的患者在跨学科环境中从 CD 中恢复症状的情况，并探讨可能导致症状严重程度变化的因素。

研究设计

回顾性队列研究。

方法

从加拿大多伦多一家门诊神经耳科跨学科诊所的 195 名成年人的图表中提取与头晕相关的诊断。2012 年 8 月至 2018 年 7 月期间，患者基线时进行了头晕残疾量表（DHI）和头晕灾难化量表（DCS）评估，并在大约 10 个月内进行了平均随访。研究参与者被归类为“LTD/LC+”（n=92）或“LTD/LC-”（n=103），分别指接受或寻求 LTD/LC 或不寻求 LTD/LC。

结果

LTD/LC+和 LTD/LC-患者的 DHI（t[187]=3.02，P=0.003）和 DCS（t[179]=2.63，P=0.009）评分的平均百分比变化存在差异。LTD/LC+患者的 DHI 和 DCS 评分分别平均增加 8.0%和 7.6%，而 LTD/LC-患者的 DHI 和 DCS 评分分别平均减少 21.5%和 25.9%，控制年龄、性别和基线疾病严重程度。