Psychiatric aspects of dizziness: a question of balance

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Dizziness is a common complaint and one that is mysterious for the patient and hard to communicate to the doctor. Persistent dizziness has been termed a 'heart-sink' complaint by general practitioners.

Dizziness, giddiness, vertigo, unsteadiness and abasia can all describe the symptoms of this topic. However, vague terminology obscures any true understanding as to why some patients have subjective unsteadiness. Usually diagnosed by their GP as labyrinthitis, patients fail to be treated by an ear, nose and throat specialist or a neurologist, and may end up as a psychiatric referral.

Patients are sometimes resentful for being referred to a psychiatrist, and general psychiatric practitioners who are used to dealing with more serious mental illnesses may feel their time is being wasted. Psychiatric dizziness is not easy to research in standard textbooks and its very vagueness calls for a didactic, easily assimilated approach.

As a consultant psychiatrist you already have basic knowledge of general medicine and neurology, as well as detailed knowledge of clinical psychiatry and psychology, which will allow you to assist in the elucidation and treatment of clinical areas such as this. This module aims to alleviate the topic from unhelpful conceptualisation, and thus improve doctors’ sense of familiarity and competence in helping patients suffering from psychiatric dizziness.

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