Prell Tino, Finn Sigrid, Zipprich Hannah M, Axer Hubertus
Department of Geriatrics, Halle University Hospital, 06120 Halle, Germany.
Center for Vertigo and Dizziness, Jena University Hospital, Friedrich Schiller University, 07743 Jena, Germany.
J Clin Med. 2022 Apr 3;11(7):2005. doi: 10.3390/jcm11072005.
Vertigo and dizziness are common in community-dwelling people and can be treated in specialized multidisciplinary settings. To develop tailored interventions, however, we have to explore risk factors for favorable and unfavorable outcomes.
We prospectively investigated patients with chronic vertigo and dizziness subjected to our 5-day multimodal and interdisciplinary day care treatment in the Center for Vertigo and Dizziness of Jena University Hospital, Germany. The Vertigo Severity Scale (VSS), the Body Sensations Questionnaire (BSQ), the Hospital Anxiety and Depression Scale (HADS), the Agoraphobic Cognitions Questionnaire (ACQ), the Mobility Inventory (MI), and the burden and intensity of dizziness (using a visual analogue scale) were assessed at baseline ( = 754) and after 6 months ( = 444). In addition, 14 Likert-scaled questions were used to quantify the change in personal attitude and behavior towards the complaints after 6 months.
Dizziness-related burden and intensity improved with a large effect size. The largest improvement was seen in the attitudes towards dizziness, the understanding of somatic causes, and the perceived ability to influence dizziness. However, the ability to work and to carry out professional activity was improved to a lesser extent. The overall improvement of dizziness was associated with the absence of a depressive mood, a short duration of vertigo, a lower VSS, a lower perceived intensity of vertigo, and distinct vertigo diagnoses, namely Meniere's disease, vestibular migraine, vestibular neuritis, vestibular paroxysmia, and vestibular schwannoma. Worsening of dizziness/vertigo was associated with depressive symptoms, permanent vertigo, distinct vertigo diagnoses (central vertigo, multisensory deficit), and a higher perceived burden due to vertigo.
The six-month outcome of patients with dizziness presented to a specialized outpatient clinic appears to be favorable. Nevertheless, people with the abovementioned risk factors at baseline have less benefit and probably need adapted and tailored vertigo interventions to improve long-term outcome.
眩晕和头晕在社区居民中很常见，可在专门的多学科环境中进行治疗。然而，为了制定针对性的干预措施，我们必须探索有利和不利结果的风险因素。
我们对德国耶拿大学医院眩晕与头晕中心接受为期5天的多模式跨学科日间护理治疗的慢性眩晕和头晕患者进行了前瞻性调查。在基线时（n = 754）和6个月后（n = 444）评估眩晕严重程度量表（VSS）、身体感觉问卷（BSQ）、医院焦虑抑郁量表（HADS）、广场恐怖认知问卷（ACQ）、活动量表（MI）以及头晕的负担和强度（使用视觉模拟量表）。此外，使用14个李克特量表问题来量化6个月后个人对这些症状的态度和行为变化。
与头晕相关的负担和强度有显著改善。在对头晕的态度、对躯体原因的理解以及对影响头晕能力的感知方面改善最为明显。然而，工作和开展职业活动的能力改善程度较小。头晕的总体改善与无抑郁情绪、眩晕持续时间短、VSS较低、眩晕感知强度较低以及明确的眩晕诊断（即梅尼埃病、前庭性偏头痛、前庭神经炎、前庭阵发性眩晕和前庭神经鞘瘤）有关。头晕/眩晕加重与抑郁症状、持续性眩晕、明确的眩晕诊断（中枢性眩晕、多感觉缺陷）以及较高的眩晕感知负担有关。
到专门门诊就诊的头晕患者6个月的预后似乎良好。然而，基线时具有上述风险因素的患者获益较少，可能需要调整和定制眩晕干预措施以改善长期预后。
