February 16, 1994
Media Contact:Joann Rodgers
Phone: (410) 955-6680
E-mail: JRodgers@welchlink.welch.jhu.edu

...they're seen by physicians as frustrating or irritating they don t get better, they keep coming back...

Nearly half of a doctor's patients who complain of dizziness may have significant psychiatric problems, according to a study by Johns Hopkins psychiatrist Michael R. Clark; M.D., M.P.H., and researchers from the University of Washington, Seattle, and the University of Texas at San Antonio.

Dizziness, sometimes called vertigo, is among the top 10 reasons patients see primary care physicians, national surveys point out. "It's the third most common reason people older than 65 visit the doctor and, in patients older then 75, it becomes the most common complaint," says Clark.

This study of 75 patients, referred to a specialist because of dizziness, compared those with a definable inner-ear disorder to those without. Both groups, Clark found, had higher than normal levels of anxiety or depression.

"But those without an inner-ear problem," says Clark, "had a dramatically increased incidence of major depression, panic disorder or somatization." (Somatization occurs, psychiatrists say, when a person converts a mental state into a body symptom)

In the study, published in a recent issue of the Archives of Internal Medicine researchers administered a series of psychiatric diagnostic tests, including ones for depression and anxiety. In addition, an otolaryngologist (ear, nose and throat specialist) assessed each patient using NM and a battery of neurological tests.

Traditionally, says Clark, the patients who don't "pass" the physical tests are "reassured that they are OK and sent home with no treatment. This is unfortunate, because they are every bit as incapacitated as someone with an inner-ear problem and they often can be helped."

"This is a population that's seen by physicians as frustrating or irritating", Clark says. "They don't get better; they keep coming back. Meanwhile, they suffer and they are definitely disabled - they may not be able to go to work, to have normal relationships with others."

"If you treat the psychiatric disorder, you find that either their physical complaints are greatly reduced, don't preoccupy them as much or completely go away," Clark says.

Co-researchers were Mark Sullivan, M.D., Ph.D.; Wayne Katon, M.D.; Joan Russo, Ph.D.; and Richard Voorhees, M.D., of the University of Washington, and Robert Dobie, M.D., at the University of Texas.

Funding for the study was from NIH and the University of Washington, Seattle.

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