Multiple Psychovegetative Symptoms
The article (1) is obviously a very thorough explanation of physical symptoms, or syndromes, of vertigo, which is based on a wealth of experience. Unfortunately, such vertigo by no means occurs in all affected patients, even in our specialized outpatient clinic, and hardly any attention is paid to the fact that isolated vertigo is very rare, since it is almost always embedded in a multitude of psychovegetative symptoms—a perspective from which vertigo is the lead symptom only for certain specialties: otolaryngology and neurology. The number of “vertigo patients” in non-specialized practices is high, as investigations have shown, so that the number of symptoms that cannot be captured with organic causes is correspondingly higher in such practices than in specialized outpatient clinics (2). But even in the mentioned publication, the rate of disorders that cannot be explained with organic causes is 35%, and if patients with Menière’s disease are included, which is a non-controversial approach for doctors with a psychosomatic approach, then this rate rises to 45%.
What happens to such patients, who in a specialized outpatient clinic ultimately do not receive adequate help? Except for the administration of citalopram in “phobic vestibular vertigo,” the authors do not share any therapeutic recommendations. Adequate psychological diagnostic evaluation is apparently also not undertaken. This should no longer be the case in these times with training opportunities for “basic psychosomatic care” and in view of the existence of specialists for psychosomatic medicine.
Dr. med. habil. Hans Konrad Eichhorn
Weil am Rhein
Conflict of interest statement
The author declares that no conflict of interest exists.
|1.||Strupp M, Dieterich M, Brandt T: The treatment and natural course of peripheral and central vertigo. Dtsch Arztebl Int 2013; 110(29–30): 505–16 VOLLTEXT|
|2.||Kütemeyer M, Schultz-Venrath M: Psychosomatische Medizin. In v. Uexküll, 5th edition, Urban u. Schwarzenberg 1996: 1067 ff.|