Introduction: Ménière’s disease (MD) is an inner ear disorder, characterized by vertiginous attacks, fluctuating sensorineural hearing loss, tinnitus, and a feeling of ear fullness. Endolymphatic hydrops has been proven as the underlying pathology. Frequently, psychopathologies accompany the disease. The aim of this study was to investigate the correlation of anxiety and depression with demographic, clinical, and audio-vestibular findings in MD patients. Methods: The study included 40 consecutive unilateral MD patients. Demographic data (age, sex, education, employment, and marital status), clinical variables of drop attacks, the duration, frequency and severity of vertigo attacks, and tinnitus disturbance levels were recorded. Hearing threshold levels were graded between 1 and 4. Vestibulometric variables were taken as the presence of saccades and vestibulo-ocular reflex (VOR) gain deficits in the video head impulse tests (vHIT) and canal paresis in bithermal caloric tests. Becks’s depression and anxiety scales were used for psychometric evaluations and graded by 4 and 5 from normal to severe and normal to very severe, respectively. Results: The median age of the patients was 48.94 years, and the numbers of both sexes were almost equal (male/female = 19/21). All patients reported at least one vertigo attacks within the last year. The duration of attacks was most commonly (62.5%) 1–3 h, ranging from #x3c;1 h to 17 h. Most attacks were graded as mild (67.5%), and the frequency was 2–3 episodes per year in 22 (55%) patients. The number of attacks within the last year was 1–12. Three patients reported having drop attacks. Hearing loss in the affected ear was moderate/moderately severe in 20 (50%) patients. Thirty-seven (92.5%) patients had complaints of tinnitus. In vHIT, saccades and VOR gain deficits were found in 33 (82.5%) and 11 (27.5%) patients, respectively. Canal paresis was present in 18 (45%) patients. The depression and anxiety rates were 35% and 90%, respectively. Depression scores were correlated with education, marital status, and the presence of saccades. Anxiety was correlated only with tinnitus severity and VOR gain deficits. Depression and anxiety were also correlated. Conclusion: Vertigo appears to be more intrusive than the other MD symptoms, and a higher correlation with anxiety than depression was demonstrated in this cohort. However, depression was seen less among married and educated patients, suggesting the role of coping capability, and had more pronounced clinical/vestibulometric correlates. Overall, these results indicated that it is mainly the severity of organic/physiological pathology which determines the degree of depression and anxiety in MD rather than vice versa.
Audiol Neurotol

中文翻译：

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梅尼埃病患者临床和听觉前庭测量结果与共存焦虑和抑郁的相关性

简介：梅尼埃病 (MD) 是一种内耳疾病，其特征是眩晕发作、波动性感音神经性听力损失、耳鸣和耳闷胀感。内淋巴积水已被证明是潜在的病理学。通常，精神病理学伴随着疾病。本研究的目的是调查焦虑和抑郁与 MD 患者的人口统计学、临床和听觉前庭发现的相关性。方法：该研究包括 40 名连续的单侧 MD 患者。记录人口统计数据（年龄、性别、教育、就业和婚姻状况）、跌倒发作的临床变量、眩晕发作的持续时间、频率和严重程度以及耳鸣障碍水平。听觉阈值等级介于 1 和 4 之间。前庭测量变量被视为视频头脉冲测试 (vHIT) 中存在的扫视和前庭眼反射 (VOR) 增益缺陷以及双热热测试中的耳道麻痹。Becks 的抑郁和焦虑量表用于心理评估，分别从正常到严重和正常到非常严重按 4 和 5 进行分级。结果：患者的中位年龄为 48.94 岁，男女人数几乎相等（男/女 = 19/21）。所有患者在过去一年内至少报告过一次眩晕发作。攻击持续时间最常见 (62.5%) 为 1-3 小时，范围从#x3c；1 小时到 17 小时。大多数发作被评为轻度 (67.5%)，22 名 (55%) 患者的发作频率为每年 2-3 次。去年的攻击次数为 1-12 次。三名患者报告有跌倒发作。20 名 (50%) 患者患耳的听力损失为中度/中度严重。37 名 (92.5%) 患者主诉有耳鸣。在 vHIT 中，分别有 33 名 (82.5%) 和 11 名 (27.5%) 患者出现扫视和 VOR 增益缺陷。18 名 (45%) 患者存在耳道麻痹。抑郁和焦虑的发生率分别为 35% 和 90%。抑郁评分与教育、婚姻状况和眼跳的存在相关。焦虑仅与耳鸣严重程度和 VOR 增益缺陷相关。抑郁和焦虑也相关。结论：眩晕似乎比其他 MD 症状更具侵扰性，并且在该队列中证明与焦虑的相关性高于抑郁症。然而，抑郁症在已婚和受过教育的患者中较少见，这表明应对能力的作用，并且具有更明显的临床/前庭测量相关性。总的来说，这些结果表明，主要是器官/生理病理的严重程度决定了 MD 患者的抑郁和焦虑程度，而不是相反。
听觉神经醇