SYMPTOMS AS A CLUE TO OTOLOGIC AND PSYCHIATRIC-DIAGNOSIS IN PATIENTS WITH DIZZINESS

Dizziness is a common symptom that often remains unexplained despite e xtensive medical evaluation. Psychiatric disorders are usually conside red only after all medical causes of dizziness have been ruled out. Si xty-five patients referred to an otolaryngology practice received a st ructured psychiatric interview, an otologic evaluation, and a dizzines s questionnaire modified to assess psychiatric symptoms. They were div ided into four diagnostic groups: psychiatric diagnosis only, otologic diagnosis only, both diagnoses, or neither diagnosis. Eleven question naire items were significantly associated with diagnostic groupings. S tepwise discriminant function analysis utilizing age, gender, rapid/ir regular heartbeat, extremity weakness, nausea/vomiting, and difficulty with speech resulted in correct group classification for 70% of subje cts. The presence of dizziness symptoms like vertigo or lightheadednes s was not significantly different between groups. This study suggests that assessment of psychiatric and autonomic symptoms should accompany , not follow, otologic evaluation of dizziness. These symptoms may be more important diagnostically than dizziness quality.