NEUROOTOLOGICAL AND PSYCHIATRIC ABNORMALITIES IN A COMMUNITY SAMPLE OF PEOPLE WITH DIZZINESS - A BLIND, CONTROLLED INVESTIGATION

Objectives-To determine neurootological and psychiatric abnormalities associated with complaints of dizziness in an epidemiological communit y sample of people of working age, and the extent of comorbidity betwe en neuro-otological and psychiatric dysfunction. Method-A survey of 38 84 people randomly selected from six general practice lists identified 262 people with significant dizziness, from which a subsample of 15 m en and 22 women were recruited for testing. Dizzy subjects were evalua ted by blind neuro-otological testing, computerised dynamic posturogra phy, a computerised psychiatric assessment, neuro-otological and gener al medical examination, and diagnosis. An age matched control group of 18 men and 22 women underwent the same evaluation. Results-Tests of a uditory, vestibular, and oculo-motor function did not discriminate bet ween dizzy subjects and controls, but dizzy subjects had significantly worse balance on posturographic testing, more diagnoses of medical di sorder, and a higher prevalence of psychiatric morbidity. Conclusions- The findings suggest that dizziness in the community is typically char acterised by mild physical disorder accompanied by some psychiatric di sturbance. As the combination of minor physical and psychiatric disord er is known to be unusually persistent and handicapping, treatment pro grammes must be provided for this prevalent syndrome, perhaps by a par tnership between primary care and neuro-otological and psychiatric hos pital outpatient clinics with experience and expertise in the diagnosi s and management of dizziness and psychiatric disturbance.