Negative psychological conditions in patients with audiovestibular diseases.

I am glad some studies are acknowledging the emotional toll having vestibular diseases has on a person. Maybe doctors will be more sensitive and maybe be more apt to prescribe an antiviral to try and leave no stone unturned in helping us with our symptoms


http://www.ncbi.nlm.nih.gov/pubmed/26922128
Negative prognostic factors for psychological conditions in patients with audiovestibular diseases.

Auris Nasus Larynx. 2016 Feb 24. pii: S0385-8146(16)30043-8. doi: 10.1016/j.anl.2016.02.006. [Epub ahead of print]

Negative prognostic factors for psychological conditions in patients with audiovestibular diseases.

Sakagami M1, Kitahara T2, Okayasu T1, Yamashita A1, Hasukawa A1, Ota I1, Yamanaka T1.



Author information

1Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
2Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan. Electronic address: [email protected].

Abstract

OBJECTIVE:

To examine the backgrounds of patients with audiovestibular disease regarding what influences their psychological state.

METHODS:

During a 12-year period, 375 successive patients with audiovestibular diseases were enrolled in this study. Diseases included unilateral (n=174) and bilateral (n=51) Menière's disease, sudden deafness with vertigo (n=70), and vestibular neuritis (n=80). Diagnosis, sex, age, duration of disease, vertigo frequency, persistent nystagmus, and ipsilateral/contralateral hearing levels were recorded. Cornell Medical Index (domains III-IV=neurosis) and Self-Rating Depression Scale (score>40=depression) were applied during acute vertigo remissions in all patients.

RESULTS:

Neurosis and depression, respectively, were diagnosed in 62.7% and 82.4% of bilateral Menière's, 32.7% and 48.9% of unilateral Menière's, 15.7% and 38.6% of sudden deafness/vertigo, and 12.7% and 31.3% of vestibular neuritis patients. Multivariable logistic regression analysis showed that Menière's disease with longer disease duration (Oz 1.212; P=0.021) and worse hearing in the secondary affected ear (Oz 1.131; P=0.042); sudden deafness/vertigo with persistent nystagmus (Oz 1.895; P=0.005); and vestibular neuritis with longer disease duration (Oz 1.422; P=0.019) and persistent nystagmus (Oz 1.950; P=0.0003) had mental illness significantly more often than those with shorter-duration disease, better hearing and no persistent nystagmus.

CONCLUSION:

Mental disorder increased in accordance with solo vertigo, vertigo/hearing loss, repeated symptoms, and bilateral lesions. Treatment strategies should be carefully constructed for patients with persistent nystagmus, long disease duration, and hearing loss in the secondary affected ear to avoid psychological disorders.

Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

 

no problem bythebay, but many times our own family and friends do not even realize the emotional toll it takes on us.
To us, people with MM its so obvious, but many times we are very misunderstood.

 

I agree as many of us do that stress can bring on Meniere's symptoms. I don't think Drs take in account the amount of stress vertigo causes or else we would not be told by many of them, learn to live with it.

Chronic illnesses usually causes stress and anxiety but its the degree of stress and anxiety that living with vertigo causes. We live in fear, that's a very heightened sense off anxiety.

Also there is the Quality of Life scale that equates different diseases with the quality of life and having Meniere's the quality of life is equated to a terminal cancer patient and during an attack Meniere's patients quality of life is equated to a person dying of a terminal illness.

I think its the magnitude of the anxiety that many health professionals overlook or are not aware of.

 

I agree with you both about the stress and anxiety and how it relates to vertigo.

Docs also tend not to take into account the different personalities of their patients. Some people are naturally more anxious and get stressed more easily than others, menieres notwithstanding.

I'm not one to get overly upset about things, even during vertigo, but having said that, when I was having non stop, daily bouts of vertigo, 12 hours duration, I was stressed and got to the point where I didn't want to leave the house. It must be horrible for personality types that are prone to anxiety.

Thanks for another though provoking article, Vicki

Maggie

 

You're very welcome, I think its important for doctors to be aware of how intense the anxiety can be when one is having vertigo, then they might be more apt to let their patients try an antiviral, even if they don't think it would work, or w/e they hesitate about prescribing one for MM. Realizing the depth and intensity of how living with vertigo makes one feel might do the trick, at least I would hope since they supposedly wanted to help people and that's why they became doctors.

Not ever experiencing vertigo on a regular basis, is hard for anyone to know what it is really like, but if they read studies like the one above and understand how life altering it is and how much it affects our mental state..it might leave them more open to try and help us find a way to get vertigo relief.

 

Trust me, imback, my first few vertigo attacks were not handled all that well. Mine last at least 12 hours maybe more. I hated them when they were happening and i was angry that I had to endure them, but luckily I didn't get anxiety over them.

I came to realize that the less I fought the vertigo, and just succumbed until it ran it's course, the "easier" they were to endure. I always welcome the chills, because that is my signal that the vertigo is stopping .

I feel bad for people who are anxious by nature because I think that exacerbates what is already a horrible experience.
I agree that do tors need to know the psychological aspects of this disease.

Maggie

 

I think its safe to say stress is a trigger for most if not all of us but, even if we had anxiety before Meniere's I am pretty sure a majority of MM patients' anxiety and stress level increased significantly after developing it. That is what I think doctors and family and friends don't get as a rule, the intensity of the anxiety we have waiting or anticipating the next attack and the anxiety of feeling off balance on a daily basis.
I would try to explain it as I don't feel safe in my own body because I never know what and when it is going to do. Feeling unsafe causes intense anxiety at least for me it does.
If you cant trust your body (aka inner ear) to keep you safe you basically don't feel safe anywhere.
If someone hasn't experienced a vertigo attack they just cant imagine how violent it is.

 

good reply to your hubby Marta
Since I have MM at such an young age I ran into a lot people friends and family included who never understood what I was dealing with. Back then most never even heard of Meniere's.
I was misunderstood by many even my own family who labeled me back then as lazy and a quitter. (I am neither of those and they now know I was falsely labeled) I had wished back then for anyone who could not grasp what my life was like growing up having Meniere's to experience a vertigo attack once or twice. I did not wish them to have Meniere's, I just wanted them to see what I had to deal with. It might sound mean but I just wanted to be understood.

 

aww Marta so sweet! imback and Sharon thank you. My purpose for letting people know I have MM for 50 years, and I got through it, is to hopefully give them the strength and hope to keep the faith. Because now there are so many treatments and options that no one would have to endure 5 decades today having MM not even 1.

With antivirals, JOH, allergy shots, MAV being a possible cause with its own treatments, antifungals, possible TMJ causing the MM like symptoms, the EDB out patient surgery, inner ear injections, meniette box and the list goes on and on, I think most if not all can find symptom relief within one years time if not sooner with trial and error, and if all else fails there is the laby and VNS.

I had none of these options until recently. And I am so incredibly lucky that antivirals give me such amazing symptoms relief.

 

Sharon I love the explanation your PCP gave and it is spot on! and you will find your answer hopefully in April