Clinical features of 17 patients with dizziness speculated to be primarily related to psychological factors

The purpose of the present study was to clarify the clinical features of physiologically induced dizziness and psychogenic dizziness in which psychological factors appeared to play a primary role in onset and continuation. Seventeen patients (8 males and 9 females) who had undergone psychotherapy at our clinic participated in this study. Their ages ranged from 16 to 61 years (mean, 28.1 years). On the basis of the patient's clinical records, dizziness was divided into two categories: persistent, non-rotary vertigo, e.g. a floating sensation while walking (8 cases); and conditioned dizziness that was precipitated under certain circumstances and could not be explained physiologically (9 cases). One patient complained of a vertigo attack induced by seeing a specific character, another complained that vertigo occurred when he imagined sour food, and four teenagers had dizziness attacks only during school classes. At the first consultation, all patients described their dizziness as severe, but a later questionnaire survey revealed that their physical activities in daily life, such as turning their heads, running, and walking up/down the stairs, were not significantly impaired. The survey also showed that these patients had various associated symptoms such as anxiety, tension, or fear and less frequently general fatigue, stiff shoulder, and insomnia. All these symptoms had diminished at the time of the questionnaire survey. Bilateral low-tone sensorineural hearing loss was noted in most of these patients. The findings in the present study also showed that even when dizziness did not improve after psychotherapy, the improvement in associated symptoms significantly enhanced patient satisfaction.