Cognitive-behavioural therapy for chronic subjective dizziness: Predictors of improvement in Dizziness Handicap Inventory at 6 months posttreatment

概要

Background: Chronic subjective dizziness (CSD) has a great impact on patients’ quality of life. As of 2017, CSD was superseded by persistent postural-perceptual dizziness. Cognitive-behavioural therapy (CBT) is a promising treatment, with demonstrated effectiveness as a CSD treatment; however, no studies have examined positive predictors of its effectiveness in the long term.

Aims/objectives: The aim of this study was to examine predictors of improvement in the Dizziness Handicap Inventory (DHI) in patients with CSD at 6months after CBT.

Materials and methods: 37 patients with CSD who were enrolled from April 2012 to November 2014 and completed group CBT were analysed. Single and multiple regression analyses with forward–backward stepwise model selection method was used to examine the independent predictors of long-term improvement in the change score of DHI.

Results: Presence or absence of comorbid anxiety disorders (p=.023) was a significant positive predictive factor for improvement of DHI from pretreatment to 6 months posttreatment.

Conclusions and significance: The presence of comorbid anxiety disorders predicted considerable improvement of DHI from pretreatment to 6 months posttreatment. Group therapy including interoceptive exposure using vestibular rehabilitation, along with psychoeducation and behavioural experiments with graded exposure, may be particularly suitable in treating patients with CSD.