پریشانی های روانی و ناتوانی در بیماران مبتلا به سرگیجه
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|34005||2001||5 صفحه PDF||سفارش دهید||محاسبه نشده|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Journal of Psychosomatic Research, Volume 50, Issue 6, June 2001, Pages 319–323
Objective: Vertigo is an extremely debilitating experience for the patient, especially during attacks; it is neither easy to identify nor control. The importance of psychosomatic factors has already been widely studied and discussed. In particular, it has been shown that stress factors are relevant in setting off episodes of dizziness, but there is no agreement if the presence of distress might influence the vestibular disability. Methods: This study is concerned with evaluating the quality of life (QOL) in a group of 206 patients suffering from vertigo and 86 control patients, using the UCLA-Dizziness Questionnaire (UCLA-DQ) scale. The results were correlated with those achieved using the Hospital Anxiety and Depression Scale (HADS) psychometric test. Results: What is clear is that, in patients suffering from vertigo as regards those who are not, there is a significant amount of anxiety and depression distress, especially in female subjects. There appears to be no relationship between psychological change and the various forms of clinical vertigo. In terms of the QOL parameter, what emerges is that, from a statistical point of view, fear of becoming dizzy is most closely correlated with the perception of disability. Conclusions: There is a also a need for psycho-education here in collaboration with the E.N.T. specialist so that the patient can learn to recognise his/her medical condition and be aware of the factors that primarily contribute to the deterioration of their QOL.
Vertigo is a psychologically disabling symptom for at least three reasons. Firstly, it is hard to identify and/or to see physically, and therefore, patients easily fail to locate its source  and thus become potentially prone to somatization. Secondly, since vertigo arousal is often unforeseeable, the fear of a new episode is probably the most common complaint among patients with vestibular disorders , and their tendency to anxiety and panic is well established  and . Thirdly, it induces a profound involvement of both body and mental sensations . There is no generally accepted clinical test that measures vestibular sensation or any aspects of subjective vestibular disability resulting from an altered vestibular sensory function or, more generally, orientation . Further, it is also suspected that comorbidity of psychopathological factors and vestibular disorders is involved in the experience of vertigo , , , , ,  and  even though research to assess these factors in controlled studies has been limited  and . In particular, Menière's disease has been studied , , ,  and , but the results have been contradictory . Some experiments  and  confirm that anxiety and agoraphobia are respectively associated with enhanced nystagmic responses to caloric testing and with impaired upright balance in response to critical proprioceptive cues. This data may support the hypothesis that patients with psychological distress could perceive a stronger rotational vertigo and unsteadiness than patients in a normal mood should, if a vestibular dysfunction occurs. Therefore, vestibular disability seems to arise primarily from psychological distress rather than from clinical conditions ,  and . In the present study, the first aim was to study whether anxiety and depression distress are prevalent in a group of patients with vestibular dysfunction compared to subjects with normal vestibular function, and whether gender plays a particular role. A second objective was to establish whether anxiety and depressive symptoms are differently raised in the major categories of the vestibular diseases. The third aim was to conclusively verify if patients with raised anxiety and depression scores show higher values on a specific disability scale for vertigo.
نتیجه گیری انگلیسی
What emerges from the present study is the need to take emotional aspects and the duration of illness into great consideration during the diagnosis and treatment of patients suffering from dizziness. These patients run the risk, as indicated by other authors , ,  and , of feeling unwell, even during long healthy periods between one attack and another, as they wait for new dizzy spells to occur. This fear is the primary cause of their reduced QOL.