No6(4) 2021
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DOI 10.37219/2528-8253-2021-6-04 |
Zabolotnyi DI, Lutsenko VI, Bieliakova IA, Kholodenko TYu, Vinnichuk PV,
Hradiuk NM, Shevchenko TO
Psycho-emotional state of patients with cochleovestibular disorders occurred
under stress conditions |
Zabolotny Dmitry I.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine. Director
Doctor of Medical Sciences, Professor, Academician of the National Academy
of Medical Sciences of Ukraine
E-mail: amtc@kndio.kiev.ua
https://www.scopus.com/authid/detail.uri?authorId=6701512931
ORCID ID: https://orcid.org/0000-0001-9429-4414
Lutsenko Viktor I.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Head of Laboratory of Clinical Audiology and Vestibulology
Doctor of Medical Sciences
E-mail: vil1954@ukr.net
ORCID ID: https://orcid.org/0000-0001-6517-2223
Scopus Author ID: 57222327855
Belyakova Irina A.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Laboratory of Clinical Audiology and Vestibulology
Leading researcher
PhD
E-mail: irina1954tolay@gmail.com
Kholodenko Tetiana Yu.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Scientific Secretary
E-mail: amtc@kndio.kiev.ua
ORCID ID: https://orcid.org/0000-0002-6578-5799
Scopus Author ID: 6506250388
Vinnichuk Pavlo V.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Acting head of Department of Pediatric ENT Pathology
PhD
E-mail: vipinlov@gmail.com
Hradiuk Nataliya M.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Laboratory of Clinical Audiology and Vestibulology
Junior Researcher
E-mail: svr_lor@ukr.net
ORCID ID: https://orcid.org/0000-0003-1298-6420
Shevchenko Tetiana O.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine.
Ear Microsurgery and Otoneurosurgery Department
Junior Researcher
Candidate of Medical Sciences
E-mail: nuha1977@ukr.net
Orchid ID: https://orcid.org/0000-0002-4338-3202 |
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Abstract
Topicality: Dizziness is one of the most common symptoms in medical
practice. This symptom can be caused by many diseases. One factor which is
contributing to dizziness is mental disorders (including depression and
anxiety). The problem of psychoemotional stress in recent decades is
becoming increasingly important in the world. The COVID-19 pandemic, which
was declared by the WHO in 2020, substantially deepened that problem.
Numerous studies show that persons of working age suffer most from
psychoemotional stress. An urgent task is a selection of scales and
questionnaires for persons with dizziness caused by chronic stress.
Aim: to increase the effectiveness of diagnosis and treatment of
cochleovestibular disorders that caused under stress conditions and develop
the rehabilitation events.
Materials and methods: 95 patients aged 18 to 59 years were examined
with complaints of dizziness caused by stress conditions and 20 people in
the control group. 52 patients from main group also complained of tinnitus
and 35 of hearing loss.
The following studies were carried out for patients: audiometry in full,
listening adaptation, detection tests for central auditory disorders,
impedance measurement, short-patent auditory induced potentials (CSVP),
vestibulometry.
The questionnaire was conducted on the following scales: the questionnaire
"Comprehensive Stress Assessment" (by Shcherbatykh YuV), the Hospital scale
of Anxiety and depression (HADS), the Quality of Life Assessment Scale (by
Chaban AS) and the Holmes and Reich social adaptation scale.
Non-parametric methods were used for statistical analysis. The difference in
comparing of the two independent aggregates was considered valid at p <
0.05.
Results: All patients with psychogenic dizziness were divided into
three groups depending on the severity of stress. The first group included
21 people (22.1%) with moderate stress, the second group – 35 patients
(36.8%) with fairly pronounced stress, and at the third group were 39 people
(41.1%) in a state of severe stress (but 10 of them are on the verge of
exhaustion of the body's adaptive forces). The average indicators obtained
during the questionnaire for the inquirer "Comprehensive stress assessment"
in the 1st group were 9.0 (10.5-7) points, in the 2nd group – 17.5 (21-14.5)
points and in the 3rd group – 34.0 (28-41.5).
The results of the Hospital Anxiety Scale and Depression (HADS)
questionnaire are: in 1st group more than half of the subanxiety scale
studies was normal; none of the subjects showed clinically pronounced
depression and only 3 of them (14.3%) showed subclinically pronounced
depression. In group 2nd the anxiety component is more pronounced with a
predominance of clinically expressed anxiety; depression was diagnosed only
in 37.1% with a predominance of subclinically pronounced depression. In the
3rd group on the anxiety sub-scale, the normal results had only 2 persons
(5.1%), moreover, clinical anxiety was prevalent in most patients. In
according with subscale of depression, about a third of patients have normal
indicators and almost half of the subjects tested have subclinically
pronounced depression.
According to the Holmes and Reich Social Adaptation Scale, in most cases (57
patients) there was low level of stress, 31 people had an average level of
stress and only 7 had a high.
The results of the assessment of life quality according to the Chaban A. S.
scale: in eight categories, life quality indicators decreased inversely in
proportion to the increase in the severity of stress. The best indicators
were obtained in the category of satisfaction with living conditions. The
worst indicators are in the categories of satisfaction with physical
condition and love.
Conclusions: 36.8% of the studied ones have quite pronounced stress
of emotional and physiological systems, 41.1% - state of severe stress and
10.5% - exhaustion of the body's adaptive forces.
Patients with dizziness that was caused by stress should be interviewed
using validated scales: the questionnaire "Comprehensive Stress Assessment", the Hospital Anxiety Scale and
Depression (HADS) and the Quality of Life Assessment Scale. The use of other scales to determine the
psychoemotional state and quality of life of
such patients is the subject for further researches.
In according with used questionnaires from 7.4 (Holmes and Reich Scale of
Social Adaptation) up to 78.9% (Hospital Anxiety and Depression Scale (HADS))
of working-age persons who were under stress, except for otolaryngological
treatment, in need of a medical psychologist. These measures will provide an
opportunity to increase the speed of the treatment process and improve
patient’s quality of life. |
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Keywords
psychogenic dizziness, chronic stress, Hospital Anxiety and Depression Scale
(HADS), Quality of Life Assessment Scale. |
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Reference
- Neuhauser HK. Epidemiology of dizziness and vertigo. Nervenarzt.
2009;80(8):887-94.
doi: 10.1007/s00115-009-2738-9.
- Neuhauser HK. The epidemiology of dizziness and
vertigo. Handb Clin Neurol. 2016;137:67-82.
doi:
10.1016/B978-0-444-63437-5.00005-4.
- Murdin L, Schilder AGM. Epidemiology of balance symptoms and disorders in the community: a
systematic review. Otol Neurotol. 2015;36(3):387-92. doi: 10.1097/MAO.0000000000000691.
- Chan Y. Differential diagnosis of dizziness. Curr
Opin Otolaryngol Head Neck Surg. 2009;17(3):
200-3.
doi: 10.1097/MOO.0b013e32832b2594.
- Wipperman J. Dizziness and vertigo. Prim Care.
2014;41(1):115-31. doi: 10.1016/j.pop.2013.10.
004.
- Karatas M. Central vertigo and dizziness: epidemiology, differential diagnosis, and common causes. Neurologist. 2008;14(6):355-64. doi: 10.1097/NRL.0b013e31817533a3.
- Post RE, Dickerson LM. Dizziness: a diagnostic
approach. Am Fam Physician. 2010;82(4):361-8.
- Bazarov VG. [Clinical vestibulometry]. Kyiv:
Zdorovia; 1988. 200 p. [In Russian].
- Dieterich M, Staab JP, Brandt T. Functional (psychogenic) dizziness. Handb Clin Neurol.
2016;139:447-68. doi:10.1016/B978-0-12-801772-2.00037-0.
- Popkirov S, Staab JP, Stone J. Persistent posturalperceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness.
Pract Neurol. 2018;18(1):5-13. doi: 10.1136/practneurol-2017-001809.
- Kelm Z, Klapchar K, Kieliszak CR, Selinsky C. Psychogenic Dizziness:
An Important but Overlooked Differential Diagnosis in the Work up of
the Dizzy Patient. J Am Osteopath Assoc.
2018;118(5):e22-e27. doi: 10.7556/jaoa.2018.066.
- Roh KJ, Kim MK, Kim JH, Son EJ. Role of Emotional Distress in Prolongation of Dizziness: A
Cross-Sectional Study. J Audiol Otol. 2017;22
(1):6-12. doi: 10.7874/jao.2017.00290.
- McEwen BS. Protective and damaging effects of
stress mediators: central role of the brain. Dialogues Clin Neurosci. 2006;8(4):367-81. doi: 10.
31887/DCNS.2006.8.4/bmcewen.
- Park CL, Russell BS, Fendrich M, Finkelstein-Fox
L, Hutchison M, Becker J. Americans' COVID-19
Stress, Coping, and Adherence to CDC Guidelines.
J Gen Intern Med. 2020;35(8):2296-2303. doi:
10.1007/s11606-020-05898-9.
- Yurieva LM, Shusterman TI. [COVID-19 Pandemic: Risks to Psychological Wellbeing and Mental
Health]. Ukrains'kyi visnyk psykhonevrolohii.
2020;28(2):5-10. https://doi.org/10.36927/2079-0325-V28-is2-2020-1. [Article in Ukrainian].
- Stone AA, Schneider S, Broderick JE. Psychological stress declines
rapidly from age 50 in the United States: Yet another well-being paradox. J Psychosom Res. 2017;103:22-8. doi: 10.1016/j.jpsychores.2017.09.016.
- Sahu GK, Upadhyay S, Panna SM. Salivary alphaamylase activity in human beings of different
age groups subjected to psychological stress. Indian J Clin Biochem. 2014;29(4):485-90. doi: 10.1007/s12291-013-0388-y.
- Shcherbatykh YuV. [Psychology of stress and
methods of correction]. St. Petersburg: Piter; 2006.
256 p. [In Russian].
- Agaev NA, Kokun OM, Pishko IA, Lozinskaya
NS, Ostapchuk VV, Tkachenko VV. [Collection of
techniques for diagnosing negative mental states of
servicemen]: Methodological guide. Kyiv: Scientific Research Center for Humanitarian Problems
of the Armed Forces of Ukraine; 2016. 234 p. [In
Ukrainian].
- Chaban OS, Khaustova OO, Bessheyko VG,
Moskalenko OV. [Validation of the "Scale for assessing the quality of life"]. Ukrains'kyi visnyk
psykhonevrolohii. 2017;25(1):159-60. [Article in
Ukrainian].
- Holmes TH, Rahe RH. The Social Readjustment
Rating Scale J Psychosom Res. 1967;11(2):213-8.
doi: 10.1016/0022-3999(67)90010-4.
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