Table 1. shows the basic demographical data of the patients, along with the summarization of the DHI and BDI results.
Table 1
Basic demographical data, BDI and DHI results.
Age (mean ± SD years) | 56.1 ± 13.4 |
Gender (male/female) | 82/219 |
Duration of the symptoms (vertigo or dizziness; mean ± SD months) | 93.2 ± 76 |
DHI, n (mean ± SD) | |
normal handicap (0-14) | 41 (7.5 ± 4.1) |
mild handicap (16-34) | 90 (23.3 ± 5.2) |
moderate handicap (36-52) | 69 (42.9 ± 4.5) |
severe handicap (54<) | 101 (71.5 ± 9.3) |
Functional score (mean ± SD) | 17.43 ± 9.5 |
Physical score (mean ± SD) | 10.5 ± 5.1 |
Emotional score (mean ± SD) | 13.74 ± 8.4 |
BDI, n (mean ± SD) | |
normal (0-5) | 172 (2.3 ± 1.3) |
mild (6-11) | 85 (7.8 ± 1.5) |
moderately severe (12-15) | 25 (12.3 ± 2) |
severe (15<) | 19 (21 ± 2) |
As shown in Table 1., the investigated patients were predominantly females, mostly in their fifties. The total DHI score indicated impaired QoL in 86.4% of the patients, with severe QoL worsening in 33.6%. The highest mean values were detected in the functional DHI subscore, followed by emotional scores. According to the results of BDI, depression was present in 42.3%, of which was in the severe range in around 6.3% of the patients.
To analyze whether the duration of the different disorders, i.e., the time from the onset of the symptoms (i.e., vertigo or dizziness) up to the completion of the questionnaire have influence on the scores or not, dot curves were drawn, and correlation tests were applied.
As shown in Fig. 1., no linear correlation was observed between the duration of the disorders and the total BDI and DHI scores, either. The Spearman test did not indicate correlation neither in case of DHI (rho=0.05, p=0.468), nor in case of BDI (rho=0.030, p=0.658) scores, thus, non-linear correlation was not observed either. Therefore, it can be concluded that the duration of the symptoms has no significant influence on QoL and the occurrence of depressive symptoms.
The distribution of the total DHI scores of the patients suffering from the different disorders are shown in Fig. 2.
As shown in Fig. 2., lower values of total DHI scores were detected in case of patients suffering from BPPV, MD, VN, and vestibular Schwannoma (Group 1). In case of Schwannoma patients, all DHI scores were in the normal range, indicating no QoL worsening. In terms of central vestibular disorders, VM, PPPD and unilateral peripheral vestibulopathy (Group 2), higher total DHI values were observed, and about 50% of the scores were found in the severe range. When statistical analysis was carried out using the Mann-Whitney U test, significant difference was detected between Groups 1 and 2 (z-score: -4.23, p<0.0001), indicating significantly higher values in Group 2 (i.e., central vestibular disorders, VM, PPPD and unilateral peripheral vestibulopathy). Therefore, patients suffering from the aforementioned disorders have reported significantly worse QoL.
Figure 3. Boxplot showing the distribution of the total BDI values. Black lines in the boxes: median values, box: the middle 50% of the data, whiskers: upper and lower 25%. (a): normal range (0-5 points), (b): severe range (16+) of the BDI scores. 1: BPPV, 2: MD, 3: VN, 4: vestibular Schwannoma, 5: central vestibular disorders, 6: VM, 7: PPPD, 8: unilateral peripheral vestibulopathy.
As shown in Fig. 3., for the total BDI scores, roughly the same distribution was detected as in case of the total DHI scores. Higher BDI values were observed in Group 2, indicating higher BDI scores of patients with central vestibular disorders, VM and PPPD. Only patients suffering from unilateral vestibulopathy presented lower BDI values, than for total DHI. According to statistical analysis, which was conducted using the Mann-Whitney U test, the difference between the two groups was statistically significant in this case as well (z-score: -4.33, p<0.00001). This result indicates that besides the higher DHI values of this group the severity of depressive symptoms was more expressed as well.
The same analysis was conducted for the depression scores according to the SCL-90-R questionnaire. The results are shown in Fig. 4.
Figure 4. shows that higher depression scores based on the SCL-90-R questionnaire were observed in terms of central vestibular disorders, VM, PPPD and unilateral peripheral vestibulopathy. When the values were contrasted using the Mann-Whitney U test, a statistically significant difference was detected (z-score: -3.93, p=0.00008). This result also indicates the similar scores and depression severity, based on BDI and SCL-90-R, respectively.