A conceptual structure and methodology for the systematic approach to the evaluation and treatment of patients with chronic dizziness

The patient with chronic dizziness should never be labeled with psychogenic dizziness. Chronic does not mean psychogenic. Chronic means that health ca re has been unsuccessful. A systematic approach that yields a comprehensive formulation and rational treatment plan will increase the probability of a successful outcome and return to health. The four perspectives of diseases , life stories, dimensions, and behaviors provide a comprehensive yet flexi ble methodology for the evaluation of the patient in distress with chronic and disabling dizziness. The design of a comprehensive treatment plan invol ves the determination of each perspective's contribution to the patient's d istress and to what relative degree. This process recognizes that the persp ectives are distinct from one another but complementary in illuminating the various reasons for a patient's distress. The perspectives come together a s the formulation of the patient's case and offer a recipe for treatment ra ther than just a list of ingredients such as bio, psyche, and social. (C) 2 001 Elsevier Science Inc. All rights reserved.