A new retrospective cohort study of 128,306 adults found that individuals diagnosed with vestibular disorders had significantly higher rates of depression, anxiety, and antidepressant use than matched controls without such diagnoses. The study used the TriNetX electronic health record database and assessed outcomes over a 5-year period following diagnosis, with data drawn from January 2010 through January 2019. Investigators used propensity score matching to control for differences in age, sex, race, and ethnicity between groups.

The analysis identified 64,153 adults with vestibular disorders and matched them 1:1 with patients without a vestibular diagnosis. Both cohorts had a mean age of 57.7 years and were 64.6% female.

Within 5 years of diagnosis, 24.8% of patients with vestibular disorders were diagnosed with depression, compared with 18.1% in the control group. Anxiety was diagnosed in 26.8% of patients with vestibular disorders and 20.2% of controls. Antidepressant use was also higher in the vestibular group (39.2% vs 27.8%). Patients with vestibular disorders were 37% more likely to develop depression (relative risk [RR], 1.37; 95% CI, 1.35-1.40), 33% more likely to develop anxiety (RR, 1.33; 95% CI, 1.30-1.35), and 41% more likely to use antidepressants (RR, 1.41; 95% CI, 1.39-1.43) than controls.

A separate analysis focused on patients with vestibular migraines, a subtype characterized by dizziness and vertigo associated with migraine episodes. Investigators compared 1,183 patients with vestibular migraines to a matched cohort without the diagnosis. Both groups had a mean age of 46.1 years, and approximately 77% were female.

Among patients with vestibular migraines, 33.8% were diagnosed with depression and 40.2% with anxiety, compared with 16.5% and 19.9%, respectively, in the control group. The relative risk of depression was 2.05 (95% CI, 1.76-2.39), and the relative risk of anxiety was 2.03 (95% CI, 1.77-2.32). Antidepressant use was not assessed in this subgroup, as such medications are commonly prescribed for migraine treatment regardless of psychiatric comorbidity.

To improve diagnostic specificity, the study included only patients who underwent audiogram evaluation. Patients with benign or malignant brain tumors or unspecified ear diseases were excluded. All patients had at least 1 follow-up visit within a year of diagnosis.

The authors noted that vestibular disorders affect the inner ear and balance system, causing symptoms such as vertigo, dizziness, and visual disturbances that may impair daily functioning and contribute to psychological distress. The study did not assess symptom severity or the specific indication for antidepressant prescriptions, but medication use was considered a potential marker of underlying mental health conditions, especially in cases where diagnostic coding may be incomplete.

The findings suggest that patients with vestibular disorders, particularly those with vestibular migraines, face a heightened burden of depression and anxiety. The authors indicated that screening for mental health conditions in this population may be warranted.

The authors reported no conflicts of interest.

Source: OTO Open