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- Holmberg, Johan, et al.
(författare)
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One-year follow-up of cognitive behavioral therapy for phobic postural vertigo
- 2007
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Ingår i: Journal of Neurology. - : Springer Science and Business Media LLC. - 1432-1459 .- 0340-5354. ; 254:9, s. 1189-1192
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Tidskriftsartikel (refereegranskat)abstract
- Background Phobic postural vertigo is characterized by dizziness in standing and walking despite normal clinical balance tests. Patients sometimes exhibit anxiety reactions and avoidance behavior to specific stimuli. Different treatments are possible for PPV, including vestibular rehabilitation exercises, pharmacological treatment, and cognitive behavioral therapy. We recently reported significant benefits of cognitive behavioural therapy for patients with phobic postural vertigo. This study presents the results of a one-year follow-up of these patients. Methods Swedish translations of the following questionnaires were administered: (Dizziness Handicap Inventory, Vertigo Symptom Scale, Vertigo Handicap Questionnaire, and Hospital Anxiety and Depression Scale) were administered to 20 patients (9 men and 11 women; mean age 43 years, range 23-59 years) one year after completion of cognitive behavioral therapy. Results Test results were similar to those obtained before treatment, showing that no significant treatment effects remained. Conclusion Cognitive behavioral therapy has a limited long-term effect on phobic postural vertigo. This condition is more difficult to treat than panic disorder with agoraphobia. Vestibular rehabilitation exercises and pharmacological treatment might be the necessary components of treatment.
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| 2. |
- Holmberg, Johan, et al.
(författare)
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Reduced postural differences between phobic postural vertigo patients and healthy subjects during a postural threat.
- 2009
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Ingår i: Journal of Neurology. - : Springer Science and Business Media LLC. - 1432-1459 .- 0340-5354. ; 256, s. 1258-1262
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Tidskriftsartikel (refereegranskat)abstract
- Phobic postural vertigo is characterized by subjective imbalance and dizziness while standing or walking, despite normal values for clinical balance tests. Patients with phobic postural vertigo exhibit an increased high-frequency sway in posturographic tests. Their postural sway, however, becomes similar to the sway of healthy subjects during difficult balance tasks. Posturographic recordings of 30 s of quiet stance was compared to recordings of 30 s of quiet stance during a postural threat, which consisted of the knowledge of forthcoming vibratory calf muscle stimulation, in 37 consecutive patients with phobic postural vertigo and 24 healthy subjects. During quiet stance without the threat of forthcoming vibratory stimulation, patients with phobic postural vertigo exhibited a postural sway containing significantly more high-frequency sway than the healthy subjects. During the quiet stance with forthcoming vibratory stimulation, i.e., anticipation of a postural threat, the significant differences between groups disappeared for all variables except sagittal high-frequency sway. During postural threat, healthy subjects seemed to adopt a postural strategy that was similar to that exhibited by phobic postural vertigo patients. The lack of additional effects facing a postural threat among phobic postural vertigo patients may be due to an already maximized postural adaptation. Deviant postural reactions among patients with phobic postural vertigo may be considered as an avoidant postural response due to a constant fear of losing postural control.
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| 3. |
- Holmberg, Johan, et al.
(författare)
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Treatment of phobic postural vertigo A controlled study of cognitive-behavioral therapy and self-controlled desensitization.
- 2006
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Ingår i: Journal of Neurology. - : Springer Science and Business Media LLC. - 1432-1459 .- 0340-5354. ; 253:4, s. 500-506
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Tidskriftsartikel (refereegranskat)abstract
- In balance clinic practice, phobic postural vertigo is a term used to define a population with dizziness and avoidance behavior often as a consequence of a vestibular disorder. It has been described as the most common form of dizziness in middle aged patients in dizziness units. Anxiety disorders are common among patients with vestibular disorders. Cognitive-behavioral therapy is an effective treatment for anxiety disorders, and vestibular rehabilitation exercises are effective for vestibular disorders. This study compared the effect of additional cognitive-behavioral therapy for a population with phobic postural vertigo with the effect of self-administered vestibular rehabilitation exercises. 39 patients were recruited from a population referred for otoneurological investigation. Treatment effects were evaluated with the Dizziness Handicap Inventory, Vertigo Symptom Scale, Vertigo Handicap Questionnaire, and Hospital Anxiety and Depression Scale. All patients had a self treatment intervention based on education about the condition and recommendation of self exposure by vestibular rehabilitation exercises. Every second patient included was offered additional cognitive behavioral therapy. Fifteen patients with self treatment and 16 patients with cognitive-behavioral treatment completed the study. There was significantly larger effect in the group who received cognitive behavioral therapy than in the self treatment group in Vertigo Handicap Questionnaire and the Hospital Anxiety and Depression scale and its subscales. Cognitive-behavioral therapy has an additional effect as treatment for a population with phobic postural vertigo. A multidisciplinary approach including medical treatment, cognitive-behavioral therapy and physiotherapy is suggested.
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