Vestibular deficits and psychological factors correlating to dizziness handicap and symptom severity

Herdman, David; Norton, Sam; Pavlou, Marousa; Murdin, Louisa; Moss‐Morris, Rona

doi:10.1016/j.jpsychores.2020.109969

Cited by 34 publications

(30 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a precursor to the current study, we found that levels of handicap and symptom severity measured with self-report questionnaires before attending a specialist dizziness clinic were not correlated with either health care professional assessed vestibular function or diagnoses ( 29 ). In contrast, psychological factors including distress (anxiety and depression), illness perceptions, and cognitive-behavioral responses to dizziness such as avoidance of activity and focusing on symptoms were significantly correlated with handicap and severity of symptoms.…”

Section: Introductionmentioning

confidence: 55%

“…Of the 476 eligible patients eligible to participate, 185 completed the baseline questionnaire and were contacted again after 3 months (Figure 1 ). The original cross-sectional findings are presented elsewhere ( 29 ). The study was approved by the NHS Health Research Authority (16/NI/0256).…”

Section: Methodsmentioning

confidence: 99%

“…Patients underwent further testing (such as imaging or vestibular-evoked myogenic potentials) or had additional examinations when clinically indicated to reach a final diagnosis. Further information on the vestibular testing can be found in the cross-sectional article ( 29 ).…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

The Role of Prediagnosis Audiovestibular Dysfunction Versus Distress, Illness-Related Cognitions, and Behaviors in Predicted Ongoing Dizziness Handicap

et al. 2020

Self Cite

View full text Add to dashboard Cite

Objective People with chronic vestibular diseases experience variable degrees of self-perceived disability. However, longitudinal data examining the predictive validity of relevant clinical variables alongside psychological variables are limited. The present study examined whether these factors predict self-reported dizziness handicap 3 months after assessment and diagnosis. Methods Patients were recruited from a waiting list of a tertiary neuro-otology clinic and completed standardized mood, cognitive, behavioral, and dizziness handicap questionnaires before and 3 months after their initial consultation and diagnosis. All patients were clinically assessed and underwent comprehensive audiovestibular investigations. Results Seventy-three percent of participants responded at follow-up ( n = 135, 73% female, mean [standard deviation] age = 54.23 [17.53] years), of whom 88% were diagnosed with a neurotological condition. There were significant improvements in handicap, depression, and anxiety at 3 months. Thirty (22%) of 135 showed clinically meaningful improvement in handicap. The percentage of case-level depression and anxiety remained the same. Negative illness perceptions and symptom responses reduced, although participants still tended to view their condition negatively. Vestibular tests and type of diagnosis were not associated with self-reported handicap. Most baseline psychological variables significantly correlated with handicap at 3 months. When adjusting for baseline handicap and demographics, the baseline psychological variables only explained a significant ~3% of the variance in dizziness handicap at follow-up, with baseline handicap explaining most of the variance. All-or-nothing behavior was the most significant predictor. Conclusions Tertiary patients with vertigo and dizziness report negative illness perceptions and cognitive and behavioral responses to symptoms that are associated with self-reported handicap over time. Future studies are needed to investigate whether targeting these factors alongside traditional treatment approaches improves handicap in patients with chronic dizziness.

show abstract

Section: Introductionmentioning

confidence: 55%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The Role of Prediagnosis Audiovestibular Dysfunction Versus Distress, Illness-Related Cognitions, and Behaviors in Predicted Ongoing Dizziness Handicap

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…While primary motor and sensory pathways are usually intact in POCI, vertigo becomes a prodrome of it, [ 5 , 6 ] which might be helpful for early diagnosis of stroke. Clinical evidence shows that posterior circulation ischemic vertigo (PCIV) has a high risk of recurrence and is associated with mental disturbance such as anxiety and depression, [ 7 , 8 ] which should be alert by clinicians.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of acupuncture for posterior circulation ischemic vertigo

et al. 2020

Medicine

View full text Add to dashboard Cite

Background: Posterior circulation ischemic vertigo (PCIV) is one of the most complaint symptoms in clinical, and is associated with high risk of recurrence. Current studies show that acupuncture has therapeutic effect on releasing symptom as well as improving the blood flow of posterior circulation. In this review, we aim to assess the efficacy and safety of acupuncture for PCIV. Methods: Literature of clinical randomized control trials regarding acupuncture for PCIV published before August of 2020 will be searched in databases, including 5 English databases and 4 Chinese databases. For the included studies, methodological quality will be assessed according to Cochrane Risk of Bias Tool, and evidence quality will be evaluated with Grading of Recommendations Assessment, Development and Evaluation guidelines. Data analysis will be performed using Review Manager Software. Results: The primary outcomes involve changes of PCIV symptoms and blood flow velocity of vertebrobasilar. The secondary outcomes include Barthel Index, National Institute of Health Stroke Scale, clinical effectiveness, and adverse reactions. Conclusion: Based on current clinical studies, this systematic review and meta-analysis will provide evidence-based basis for the efficacy and safety of acupuncture in treating PCIV. Trial registration: The protocol for this review has been registered in the INPLASY network (Registration number: INPLASY202070116).

show abstract

“…For individuals experiencing persistent dizziness, a CBT protocol which remains contextually anchored to their experience of living with dizziness may ultimately promote better engagement with rehabilitation and improve health outcomes. We conducted a theoretical modelling prospective study which revealed the importance of a variety of illness speci c cognitive and behavioural factors in the experience of dizziness related disability [17,18]. This was drawn together with a review of the literature to develop a model speci c to dizziness (article in preparation) and we then used intervention mapping techniques [19,20] to design an intervention and detailed manual which integrated CBT methods into traditional VR.…”

Section: Introductionmentioning

confidence: 99%

Protocol for a Randomised Controlled Feasibility Study of Psychologically Informed Vestibular Rehabilitation for People With Persistent Dizziness (INVEST Trial)

Herdman

Norton

Pavlou

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Dizziness is a common complaint that often persists and leads to disability and distress. Several cognitive and behavioural responses may contribute to the neurobiological adaptations that maintain persistent vestibular symptoms. This paper will present the protocol of a two-arm parallel group feasibility randomised controlled trial designed to determine whether a fully powered efficacy trial is achievable by examining the feasibility of recruitment, acceptability and potential benefits of an integrated cognitive behavioural therapy and vestibular rehabilitation (CBT-VR) treatment for people with persistent dizziness. Methods: Forty adult patients will be recruited from a tertiary vestibular clinic with persistent movement triggered dizziness for three months or longer who have moderate-high levels of dizziness handicap. Participants will be 1:1 randomised, using a minimisation procedure, to six sessions (12-14 weeks’) of either CBT-VR (intervention arm) or VR only (control arm). Measures will be collected at baseline and 4 months post randomisation. The primary feasibility outcomes include descriptive data on numbers meeting eligibility criteria, rates of recruitment, numbers retained post randomisation, treatment adherence and an acceptability questionnaire. Treatment effects on self-report outcomes will be estimated to determine that 95% confidence intervals for the effects are consistent with anticipated effects and minimum clinically important differences, and to provide information needed for the power calculation of an efficacy trial. A nested qualitative study will be conducted post-intervention (intervention group only) to explore the acceptability of the intervention and identify any areas in need of improvement. Discussion: If a trial of CBT-VR is feasible, acceptability data will be used to enhance the intervention if needed and refine the multicentre RCT protocol. Future studies will need to consider the training required for other physiotherapists to deliver the intervention.Trial registration: ISRCTN 10420559

show abstract

Vestibular deficits and psychological factors correlating to dizziness handicap and symptom severity

Cited by 34 publications

References 50 publications

The Role of Prediagnosis Audiovestibular Dysfunction Versus Distress, Illness-Related Cognitions, and Behaviors in Predicted Ongoing Dizziness Handicap

The Role of Prediagnosis Audiovestibular Dysfunction Versus Distress, Illness-Related Cognitions, and Behaviors in Predicted Ongoing Dizziness Handicap

Efficacy and safety of acupuncture for posterior circulation ischemic vertigo

Protocol for a Randomised Controlled Feasibility Study of Psychologically Informed Vestibular Rehabilitation for People With Persistent Dizziness (INVEST Trial)

Contact Info

Product

Resources

About