Cognitive-behavioural therapy for chronic subjective dizziness: Predictors of improvement in Dizziness Handicap Inventory at 6 months posttreatment

Acta Otolaryngol. 2020 Oct;140(10):827-832. doi: 10.1080/00016489.2020.1772994. Epub 2020 Jun 16.


Background: Chronic subjective dizziness (CSD), which was superseded by persistent postural-perceptual dizziness as of 2017, has a great impact on patients' quality of life. Cognitive-behavioural therapy (CBT) is a promising treatment, with demonstrated effectiveness as a CSD treatment; however, no studies have examined positive predictors of its effectiveness in the long term.Aims/objectives: This study aimed to examine predictors of improvement in the Dizziness Handicap Inventory (DHI) in patients with CSD at 6 months after CBT.Materials and methods: Thirty-seven patients with CSD who were recruited from April 2012 to November 2014 and completed group CBT were analysed. Single and multiple regression analyses with forward-backward stepwise model selection method was used to examine the independent predictors of long-term improvement in the change score of DHI.Results: Presence or absence of comorbid anxiety disorders (p = .023) was a significant positive predictive factor for improvement of DHI from pretreatment to 6-month follow-up.Conclusions and significance: The presence of comorbid anxiety disorders predicted considerable improvement of DHI from pretreatment to 6-month follow-up. Group therapy including interoceptive exposure using vestibular rehabilitation, along with psychoeducation and behavioural experiments with graded exposure, may be particularly suitable in treating patients with CSD.

Keywords: Chronic subjective dizziness; cognitive-behavioural therapy; predictor.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Anxiety Disorders / complications*
  • Anxiety Disorders / therapy
  • Chronic Disease
  • Cognitive Behavioral Therapy*
  • Dizziness / complications
  • Dizziness / psychology
  • Dizziness / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychotherapy, Group
  • Regression Analysis
  • Treatment Outcome
  • Vestibular Diseases / complications
  • Vestibular Diseases / rehabilitation