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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.