1. めまいと心因性疾患

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  • Dizziness and psychogenic disorders

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Dizziness and psychogenic disorders, including depression and anxiety, are closely related. The diagnosis of dizziness includes not only an evaluation of vestibular dysfunction, but also a psychogenic evaluation. Using this approach, the following three different patterns of dizziness should be carefully identified: psychogenic, otogenic, and interactive. The common somatic symptoms in patients with chronic dizziness (N=145) were investigated using questions designed to assess headache, insomnia, diarrhea, constipation, stomachache, chest pain, palpitations, dyspnea, and general fatigue. The prevalent somatic symptom in patients with dizziness included general fatigue, insomnia, and headache. These symptoms are very similar to those reported for patients with anxiety and depression. Patients with dizziness clearly had several somatic complaints related to anxiety or depression that could be attributed to the dizziness. Treatments included pharmacotherapy and physical therapy (including rehabilitation for vestibular dysfunction), surgical intervention, pharmacotherapy, and psychotherapy for anxiety and depression. Pharmacotherapy using serotonin reuptake inhibitors and psychotherapy, such as autogenic training, were also performed.

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