Increased handicap in vertigo patients with a type-D personality

Abstract

We investigated the role of personality and its relationship to the symptom of vertigo, in a cross-sectional survey of 88 patients with a peripheral vestibular disorder at a tertiary referral centre. All 88 patients underwent a vestibular evaluation at the Vestibular Function Laboratory (Department of Otorhinolaryngology and Head and Neck Surgery) at Antwerp University Hospital. Five pathology groups were considered: Ménière's disease (n=29), benign paroxysmal positional vertigo (BPPV) of the posterior semicircular canal (n=23), vestibular neuritis (n=8), vestibular schwannoma (n=20), post-traumatic non-BPPV vertigo (n=8). Personality type-D was assessed with the type-D Personality Scale-16 (DS16) questionnaire. In order to evaluate whether or not subjects with a ‘distressed’ personality (type-D) perceive more handicap than others due to their vertigo symptoms, the Dizziness Handicap Inventory (DHI) scores between type-D and non-type-D subjects were compared. Secondly, we examined whether or not a type-D personality is more prevalent in Ménière's disease (MD) patients than in other patients experiencing vertigo. We found that type-D subjects had significantly higher DHI scores (DHI total score: mean 40.5, SD 25.7) compared with non-type-D subjects (mean 26.4, SD 19.9) (p=0.015). The link between type-D personality and disease severity was most pronounced in the emotional aspects of vertigo, as indicated by the DHI emotional subscale (p=0.007), and secondly in the functional aspects (DHI functional subscale, p=0.033). Type-D personality was not significantly more prevalent in MD compared to other patients with vertigo. These findings suggest that in patients with vertigo, symptom severity should be considered in view of the effect of having a type-D personality. A multidimensional approach may be valuable in the assessment of patients presenting with symptoms of vertigo, because a subgroup with type-D personality might benefit from psychological therapies.

• vertigo
• personality
• psychological profile
• type-D scale 16
• Dizziness Handicap Inventory