[Vertigo and anxiety disorders--results of interdisciplinary evaluation].

BACKGROUND

Vertigo is a common symptom that often remains unexplained despite extensive medical evaluation. Psychiatric and psychosomatic disorders are usually considered after all somatic causes of vertigo have been ruled out.

METHODS

Eighty-three patients referred to neurological or psychosomatic outpatient treatment received an extensive neurootologic and psychosomatic evaluation: one (or two) diagnostic psychiatric psychodynamic exploration(s), a structured interview, psychometric tests (SCL-90-R, STAI-G X2 and GBB). The patients were divided into four diagnostic groups: psychic causes only (psychogenic group), neurootologic causes only (somatic group), both diagnoses (psychosomatic group), neither diagnosis (group IV).

RESULTS

Twenty-three patients had organic vertigo, thirty-nine patients had psychogenic vertigo and in seventeen cases a vestibular lesion initiated the development of a neurotic disorder, particular anxiety disorder. Most of the patients of the psychogenic and psychosomatic group had anxiety or phobic disorders. The patients with psychogenic or psychosomatic symptoms of vertigo generally report a higher level of subjective distress; the periods of disability are significant longer.

CONCLUSIONS

The study suggests that assessment of psychiatric and psychosomatic symptoms should always accompany, not follow, neurootologic evaluation of vertigo. An early interdisciplinary therapy should be started to prevent the chronicity of the symptomatology.