PSYCHIATRIC AND OTOLOGIC DIAGNOSES IN PATIENTS COMPLAINING OF DIZZINESS

Background: Dizziness is a common and disabling symptom in primary car e practice, especially among the elderly. Though there are many organi c causes of dizziness, the results of medical workups are negative in the majority of patients. Methods: A total of 75 patients with dizzine ss who were referred to a community otolaryngology practice received a structured psychiatric diagnostic interview (National Institute of Me ntal Health Diagnostic Interview Schedule) and questionnaires that ass essed psychological distress as well as a complete otologic evaluation , including electronystagmogram. Patients with evidence of a periphera l vestibular disorder were compared with those without such evidence. Results: While psychiatric diagnoses were present in both those with a nd without evidence of a peripheral vestibular disorder, those without such evidence had a greater mean number of lifetime psychiatric diagn oses as defined by the Diagnostic and Statistical Manual of Mental Dis orders, Revised Third Edition, and specifically, a greater lifetime pr evalence of major depression and panic disorder. This group also more frequently met criteria for somatization disorder, had more current an d lifetime unexplained medical symptoms, and had more severe current d epressive, anxiety, and somatic symptoms. Conclusions: Psychiatric dia gnoses are common among patients with dizziness referred for otologic evaluation who do not show evidence of a peripheral vestibular disorde r. Specific psychiatric disorders should be part of the differential d iagnosis of patients who present with dizziness.