The relationship between psychological conditions and recurrence of benign paroxysmal positional vertigo: a retrospective cohort study

Abstract

Background Psychological conditions have been found to be associated with an increased risk of incident benign paroxysmal positional vertigo (BPPV). However, much less is known on whether and how psychological conditions such as anxiety, insomnia and obsessive–compulsive disorder (OCD) affect the recurrence of BPPV. Methods A retrospective cohort study of 2,612 outpatients and inpatients diagnosed with BPPV between September 2012 and August 2020. BPPV recurrence was followed up until February 2021. The Cox proportional hazard regression was used to analyze the association between psychological conditions and the risk of the first recurrence. Poisson regression was applied to analyze the association between psychological conditions and the number of recurrences in patients with at least one relapse. Results During the follow-up, 391 patients had at least one BPPV recurrence. Female BPPV patients were more likely than male patients to experience relapses than male patients, but the characteristics of BPPV recurrence (number of recurrences and duration between recurrences) did not differ between men and women. After adjustment for sex, age and comorbidities, a heightened risk of first BPPV recurrence was found to be associated with anxiety (hazard ratio [HR]: 1.30, 95% confidence interval [CI]: 1.01, 1.68) and OCD (HR: 2.15, 95% CI: 1.31, 3.52). An increased risk of first BPPV recurrence associated with insomnia was only observed in male patients (HR: 2.22, 95% CI: 1.24, 3.98) but not in female patients (HR: 0.91, 95% CI: 0.63, 1.31). None of these psychological conditions were associated with the number of recurrences in patients who experienced recurrence. Conclusions The presence of anxiety and OCD increased the risk of first BPPV recurrence, as well as insomnia for male patients. These psychological conditions were not associated with the number of BPPV recurrences. Diagnosis and treatment of these psychological conditions could be a useful strategy to prevent the recurrence of BPPV.

Assessment of Osteoporosis and Vitamin D3 Deficiency in Patients with Idiopathic Benign Paroxysmal Positional Vertigo (BPPV)

“…In addition, middle ear surgery or an autoimmunity are suspected to be involved in this process [ 26 , 27 ]. Sudden attacks of severe vertigo without coexistence of auditory symptoms, such as hearing loss or tinnitus, can evoke in patients not only anxiety and fear but also even obsessive-compulsive disorder [ 28 ]. These can be reasons why patients begin to avoid critical body positions.…”

Understanding Benign Paroxysmal Positional Vertigo (BPPV) and Its Impact on Quality of Life: A Systematic Review

“…In social situations, individuals with BPPV may feel selfconscious or embarrassed about their symptoms, leading to withdrawal from social interactions and a sense of isolation [9,[14][15][16]. The physical impacts of BPPV can also extend to emotional well-being [17]. Chronic dizziness and vertigo can lead to feelings of frustration, anxiety, and depression [17].…”

“…The physical impacts of BPPV can also extend to emotional well-being [ 17 ]. Chronic dizziness and vertigo can lead to feelings of frustration, anxiety, and depression [ 17 ]. The constant fear of vertigo episodes can take a toll on mental health, affecting overall quality of life [ 15 ].…”

“…Evaluation of the quality of life is a critical component in understanding the impact of health conditions such as BPPV on individuals [ 5 , 19 ]. Various tools and assessments are employed to measure the effects of BPPV on different aspects of daily living and overall well-being [ 5 , 17 ]. These evaluations provide valuable insights into the physical, emotional, and social dimensions of a patient's life, aiding healthcare providers in tailoring effective treatment plans and improving the overall quality of care [ 24 ].…”

“…DHI: The evaluation of the quality of life in individuals with BPPV often involves the use of specific tools and assessments designed to measure the impact of the condition on various aspects of daily life [ 5 , 17 ]. One commonly used tool is the DHI, which is a self-assessment questionnaire that evaluates the impact of dizziness and imbalance on daily activities, emotional well-being, and functional abilities [ 25 ].…”