Vestibular rehabilitation combined with cognitive behavioral therapy relieves chronic dizziness and the associated anxiety

Objective To assess the efficacy of combining vestibular rehabilitation with cognitive behavioral therapy in treating chronic subjective dizziness (CSD) and the associated anxiety. Methods A total of 98 anxious CSD patients were randomly divided into an experimental group (n=50) and a control group (n=48). All of the patients′ scores on the Hamilton anxiety scale (HAMA) were no less than 14 and their scores on the Hamilton depression scale (HAMD) were less than 18. Systematic vestibular rehabilitation was given to the patients in the control group, while this was combined with cognitive behavioral therapy for the patients in the experimental group. All patients were evaluated using a dizziness handicap inventory (DHI) and the HAMA before treatment and in the 4th and 8th week of the treatment. Results Before the treatment there was no significant difference between the 2 groups in any of the assessments. After 3 weeks of treatment, the average HAMA score, DHI total score and its factor scores had decreased significantly. Four weeks later, the average HAMA score, DHI total score and its factor scores for somatization, emotion and function had improved significantly in both groups compared with before treatment and the scores after 3 weeks. After 3 and 7 weeks of treatment, the average HAMA score, DHI total score and its factor scores of the experimental group were significantly lower than those of the control group. Conclusion Cognitive behavioral therapy amplifies the effects of vestibular rehabilitation in treating persons with CSD, in part by significantly relieving their anxiety. Key words: Vestibular rehabilitation; Cognitive behavioral therapy; Dizziness; Anxiety