Orthostatic hypotension and psychiatric comorbidities in patients with dizziness

Abstract Purpose The present study was undertaken to investigate orthostatic hypotension and psychiatric comorbidity with anxiety and depression in dizzy patients. Materials and methods Sixty-three patients with nonspecific dizziness and 27 volunteer subjects were evaluated with the head-up tilt test (HUTT) and the Standardized Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , Axis I. Results Orthostatic hypotension was induced by HUTT in 44% of patients and in 15% of volunteers ( P = .0082); we found that the incidence of anxiety and depression was significantly higher ( P < .05) in patients with nonspecific dizziness than in controls. Orthostatic hypotension was related to age but not to antihypertensive therapy and sex. Dizziness during the HUTT was reported by 49% of patients and 33% of volunteers ( P = .2469). Among patients, dizziness was found to be related to sex (female) and anxiety. A correlation between dizziness and anxiety was also present in volunteers. Head-up tilt test induced vasovagal reactions in 2 volunteers. Conclusions Orthostatic hypotension is present in a high percentage of patients with orthostatic dizziness, and anxiety and depression are an important factor in the onset of dizziness. A high percentage of abnormal responses in volunteer subjects seems to indicate that the HUTT is not indicated for routine use.