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Logo of bmcentdBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Ear, Nose, and Throat Disorders
BMC Ear Nose Throat Disord. 2012; 12: 2.
Published online Mar 22, 2012. doi:  10.1186/1472-6815-12-2
PMCID: PMC3352112
Gender differences in patients with dizziness and unsteadiness regarding self-perceived disability, anxiety, depression, and its associations
Annette Kurre,corresponding author1 Dominik Straumann,2 Christel JAW van Gool,3 Thomas Gloor-Juzi,1 and Caroline HG Bastiaenen3
1Department of Rheumatology and Institute of Physical Medicine, University Hospital Zurich, Zurich, Switzerland
2Interdisciplinary Center for Vertigo & Balance Disorders, Departments of ENT, Neurology & Psychiatry, University Hospital Zurich, Zurich, Switzerland
3Maastricht University, school CAPHRI, Department of Epidemiology and Faculty of Health Medicine and Life Sciences, Maastricht, The Netherlands
corresponding authorCorresponding author.
Annette Kurre: Annette.Kurre/at/; Dominik Straumann: Dominik.Straumann/at/; Christel JAW van Gool: C.vanGool/at/; Thomas Gloor-Juzi: Thomas.gloor/at/; Caroline HG Bastiaenen: CHG.Bastiaenen/at/
Received July 10, 2011; Accepted March 22, 2012.
It is known that anxiety and depression influence the level of disability experienced by persons with vertigo, dizziness or unsteadiness. Because higher prevalence rates of disabling dizziness have been found in women and some studies reported a higher level of psychiatric distress in female patients our primary aim was to explore whether women and men with vertigo, dizziness or unsteadiness differ regarding self-perceived disability, anxiety and depression. Secondly we planned to investigate the associations between disabling dizziness and anxiety and depression.
Patients were recruited from a tertiary centre for vertigo and balance disorders. Participants rated their global disability as mild, moderate or severe. They filled out the Dizziness Handicap Inventory and the two subscales of the Hospital Anxiety Depression Scale (HADS). The HADS was analysed 1) by calculating the median values, 2) by estimating the prevalence rates of abnormal anxiety/depression based on recommended cut-off criteria. Mann-Whitney U-tests, Chi-square statistics and odds ratios (OR) were calculated to compare the observations in both genders. Significance values were adjusted with respect to multiple comparisons.
Two-hundred and two patients (124 women) mean age (standard deviation) of 49.7 (13.5) years participated. Both genders did not differ significantly in the mean level of self-perceived disability, anxiety, depression and symptom severity. There was a tendency of a higher prevalence of abnormal anxiety and depression in men (23.7%; 28.9%) compared to women (14.5%; 15.3%). Patients with abnormal depression felt themselves 2.75 (95% CI: 1.31-5.78) times more severely disabled by dizziness and unsteadiness than patients without depression. In men the OR was 8.2 (2.35-28.4). In women chi-square statistic was not significant. The ORs (95% CI) of abnormal anxiety and severe disability were 4.2 (1.9-8.9) in the whole sample, 8.7 (2.5-30.3) in men, and not significant in women.
In men with vertigo, dizziness or unsteadiness emotional distress and its association with self-perceived disability should not be underestimated. Longitudinal surveys with specific pre-defined co-variables of self-perceived disability, anxiety and depression are needed to clarify the influence of gender on disability, anxiety and depression in patients with vertigo, dizziness or unsteadiness.
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