Vertigo as a companion through life : Empirical studies regarding psychological factors in Menière's disease

Abstract: Vertigo, tinnitus and hearing impairment constitute the cardinal symptoms in Menière'sdisease. This inner ear disorder, the aetiology of which is not fully understood, may causeconsiderable distress to the individual. Previous psychological research regardingMenière's disease has mainly focused on general personality traits. The aim of the presentwork was to make a systematic investigation of psychological factors in relation tosymptoms in Menière's disease. The theoretical frame was health psychology.In study I, it was found that perceived discomfort from Menière's disease correlated with dysphoria, anxiety, insomnia and lack of concentration. A majority of the participants reported an awareness of premonitory symptoms of vertigo attacks, and of associations among environmental, emotional and activity factors and attacks. In study II, subjective correlates of vertigo attacks were further explored, and situational and somatic factors were found to correlate with perceived disease progression. Study III showed that dysphoria and 'confidence in balance' in everyday activities were related to perceived discomfort from vertigo. In study IV, same-day associations between perceived symptoms and stress were found, but individual differences were observed. No evidence was obtained that stress occurring in the preceding days will increase symptoms in Menière's disease. In study V, cognitive stress produced at a Stroop test caused less body sway as measured on a stabilometer compared with body sway after a resting session. In study VI, it was found that ways of coping with stressful events correlated with perceived functional handicap from dizziness in Menière's disease. 'Anxiety sensitivity' also correlated with perceived handicap from dizziness.From the results it is suggested that psychological factors are important in Menière's disease and that there are individual differences in such factors in relation to symptoms. It is recommended that more attention should be devoted to psychological factors related to symptoms in order to minimise fear and uncertainty and to enhance the predictability of symptoms and the possibility of coping with this disease.