Individuals who suffer from chronic subjective dizziness (CSD) that is anxiety-related may reap significant benefits from taking a short course in cognitive-behavioral therapy (CBT), report researchers.
“As CBT is an effective treatment for anxiety disorders, it has potential application in the treatment of anxiety-related dizziness,” said Dr. Alison Mahoney of St. Vincent’s Hospital, New South Wales, Australia.
These benefits from CBT may be sustained for one to 6 six months afterwards, said the researchers.
In a study involving 44 patients who were referred for CSD treatment for unexplained dizziness, 43.2 percent met current standard criteria for generalized anxiety disorder, 36.4 percent for major depressive disorder, 38.6 percent for panic disorder, 6.8 percent for dysthymia, and 2.3 percent for social phobia, and 20.5 percent did not meet criteria for any disorder.
Treatment involved three weekly sessions which provided education on dizziness, behavioral experiments focused on the impact of attention on dizziness symptoms, exercises designed to reduce avoidance and safety behaviors, strategies for responding to dizziness, and encouragement to resume a normal lifestyle regardless of dizziness symptoms.
An analysis of patients’ questionnaire data showed significant improvements immediately after treatment compared to before treatment.
“Effects sizes from pre-treatment to six months follow-up for reductions in dizziness symptoms, disability, and functional impairment were large,” said the researchers.
Furthermore, the decline in physical symptoms and related disability found in the new study was comparable to those reported for other treatments, including selective serotonin reuptake inhibitors like Prozac and vestibular rehabilitation.
“However, they [effects of CBT] were achieved following a very brief and noninvasive treatment,” pointed out the team.
Mahoney noted that baseline anxiety scores were the best predictor for long-term disability, while the severity of pre-treatment dizziness symptoms or avoidance behaviors were not very good predictors.
“As patients with high levels of pretreatment anxiety showed higher levels of disability at six months post treatment, it is possible that interventions that target anxiety in a more focused way could further improve long-term treatment outcomes,” concluded the team.