The impact of symptoms of anxiety and depression on subjective and objective outcome measures in individuals with vestibular disorders

BACKGROUND: Anxiety and depression are common in individuals with vestibular disorders and anecdotally symptoms of these disorders have been associated with poorer scores on subjective outcome measures of dizziness and balance. It is unknown if symptoms of psychological distress impact individual outcomes with vestibular rehabilitation therapy (VRT). OBJECTIVE: To compare subjective and objective outcome measures in subjects with vestibular disorders who have symptoms of anxiety and/or depression to those who do not exhibit those symptoms. METHODS: A retrospective chart review was performed at two outpatient vestibular rehabilitation clinics. Data recorded included demographics, scores on the Positive and Negative Affective Scale (PANAS), and subjective and objective outcome measures of balance and gait. RESULTS: The PANAS scale was utilized to group subjects (N = 118) into two groups: Subjects with abnormal affect (SAA) (18.6%; N = 22) and subjects with normal affect (SNA) (81.4%; N = 96). Both groups demonstrated a statistically significant improvement in all outcome measures (p < 0.001) from evaluation to discharge. SAA subjects took longer than SNA subjects to achieve goals (p < 0.05). SAA subjects tended to have poorer outcome measure scores at both initial and final assessment, but this was not statistically significant (p > 0.05). CONCLUSIONS: Results from this study indicate that VRT is effective in treating vestibular disorders in individuals with symptoms of psychological distress such as anxiety and depression. However, individuals with these symptoms may not achieve as high of outcomes as those that do not report symptoms of psychological distress.