Presence of Anxiety and Depression Symptoms Affects the First Time Treatment Efficacy and Recurrence of Benign Paroxysmal Positional Vertigo
- PMID: 29619005
- PMCID: PMC5871662
- DOI: 10.3389/fneur.2018.00178
Presence of Anxiety and Depression Symptoms Affects the First Time Treatment Efficacy and Recurrence of Benign Paroxysmal Positional Vertigo
Abstract
Objectives: To investigate the possible effects of anxiety and/or depression symptoms on the treatment outcomes and recurrence of benign paroxysmal positional vertigo (BPPV).
Methods: This is a retrospective study conducted at a single institution. 142 consecutive patients diagnosed with idiopathic BPPV at the Department of Otology in Shengjing Hospital of China Medical University between October 2016 and July 2017 were retrospectively reviewed. 127 patients were finally included in this study. Zung self-rating anxiety scale (SAS) and Zung self-rating depression scale (SDS) were used to evaluate the presence of anxiety and/or depression, respectively, in our BPPV patients. A significant score (at or above 50 for SAS and 53 for SDS) represents the presence of clinically significant symptoms. Two-tailed Student's t-test, χ2 test, and logistic regression analysis were used as appropriate. A p value less than 0.05 was considered statistically significant.
Results: The prevalence of anxiety and/or depression symptoms in BPPV patients in the present study was 49.61%. The effectiveness of the first time canalith repositioning maneuver (CRM) was 70.08%. With weekly follow-up treatments of CRM, the success rate increased to 97.64% by 1 month. The total recurrence rate at 6-month follow-up post-cure was 14.17%. Holding all other variables constant, patients with psychiatric symptoms (Relative-risk ratio: 3.160; p = 0.027) and patients with non-posterior semicircular canal (PSC) involvement (Relative-risk ratio: 7.828, p = 0.013) were more likely to experience residual dizziness (RD) even after effective CRM treatment. Psychiatric symptoms (Relative-risk ratio: 6.543; p = 0.001) and female gender (Relative-risk ratio: 4.563; p = 0.010) are risk factors for the failure of first time CRM. In addition, BPPV patients with psychiatric symptoms (Odds ratio: 9.184, p = 0.008) were significantly more likely to experience recurrences within the first 6 months after a successful maneuver.
Conclusion: Anxiety-depression status significantly reduced the efficacy of the first time CRM and increased the risk for recurrence. Other factors, such as female gender and non-PSC involvement are also susceptible risk factors for BPPV patients to require multiple treatments and experience delayed recovery. A screening for psychiatric symptoms in BPPV patients and active treatment of these symptoms would benefit both physicians and patients in understanding and improving the prognosis of the disease and treatment options.
Keywords: anxiety; benign paroxysmal positional vertigo; canalith repositioning maneuver; depression; psychiatric symptoms; recurrence; treatment efficacy.
Figures
Similar articles
-
[Analysis of clinical features with benign paroxysmal positional vertigo in elderly patients and precautions for canalith repositioning procedure treatment].Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jan;29(1):12-6. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015. PMID: 25966546 Chinese.
-
[Efficacy of Epley maneuver in treatment of benign paroxysmal positional vertigo of the posterior semicircular canal].Vojnosanit Pregl. 2012 Aug;69(8):669-74. doi: 10.2298/vsp1208669b. Vojnosanit Pregl. 2012. PMID: 22924262 Serbian.
-
Features of Residual Dizziness after Canalith Repositioning Procedures for Benign Paroxysmal Positional Vertigo.Otolaryngol Head Neck Surg. 2016 Apr;154(4):693-701. doi: 10.1177/0194599815627624. Epub 2016 Feb 9. Otolaryngol Head Neck Surg. 2016. PMID: 26861236
-
Outcome of canalith repositioning manoeuvre in benign paroxysmal positional vertigo in children and adolescents: A systematic review.Clin Otolaryngol. 2023 May;48(3):371-380. doi: 10.1111/coa.14038. Epub 2023 Jan 20. Clin Otolaryngol. 2023. PMID: 36640123 Review.
-
Modifications of the Epley (canalith repositioning) manoeuvre for posterior canal benign paroxysmal positional vertigo (BPPV).Cochrane Database Syst Rev. 2012 Apr 18;2012(4):CD008675. doi: 10.1002/14651858.CD008675.pub2. Cochrane Database Syst Rev. 2012. PMID: 22513962 Free PMC article. Review.
Cited by
-
Understanding Benign Paroxysmal Positional Vertigo (BPPV) and Its Impact on Quality of Life: A Systematic Review.Cureus. 2024 Jun 24;16(6):e63039. doi: 10.7759/cureus.63039. eCollection 2024 Jun. Cureus. 2024. PMID: 39050283 Free PMC article. Review.
-
Anxiety characteristics in benign paroxysmal positional vertigo: first vs. recurrent episodes.Eur Arch Otorhinolaryngol. 2024 Jun;281(6):3245-3251. doi: 10.1007/s00405-024-08615-y. Epub 2024 Apr 4. Eur Arch Otorhinolaryngol. 2024. PMID: 38573513 Free PMC article.
-
Associations between cognition, anxiety, depression, and residual dizziness in elderly people with BPPV.Front Aging Neurosci. 2023 Aug 31;15:1208661. doi: 10.3389/fnagi.2023.1208661. eCollection 2023. Front Aging Neurosci. 2023. PMID: 37719876 Free PMC article.
-
The effect of accompanying anxiety and depression on patients with different vestibular syndromes.Front Aging Neurosci. 2023 Aug 1;15:1208392. doi: 10.3389/fnagi.2023.1208392. eCollection 2023. Front Aging Neurosci. 2023. PMID: 37593373 Free PMC article.
-
Investigation of the Relationship Between BPPV with Anxiety, Sleep Quality and Falls.Turk Arch Otorhinolaryngol. 2022 Dec;60(4):199-205. doi: 10.4274/tao.2022.2022-8-6. Epub 2023 Jul 7. Turk Arch Otorhinolaryngol. 2022. PMID: 37456598 Free PMC article.
References
-
- Dizziness Diagnostic Process Recommendation Expert Group. Guideline for the diagnosis of dizziness (in Chinese). Chin J Int Med (2009) 48(5):435–7.10.3760/cma.j.issn.0578-1426.2009.05.030 - DOI
-
- Fife TD, Iverson DJ, Lempert T, Furman JM, Baloh RW, Tusa RJ, et al. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the quality standards subcommittee of the American Academy of Neurology. Neurology (2008) 70(22):2067–74.10.1212/01.wnl.0000313378.77444.ac - DOI - PubMed
LinkOut - more resources
Full Text Sources
Other Literature Sources
Miscellaneous