2014 年 73 巻 4 号 p. 223-228
I described how, as an otolaryngologist, I have assessed psychological factors such as depression in patients complaining of vertigo/dizziness. First of all, otolaryngologists need to clarify whether patients have somatic disorders using the latest techniques. And then, otolaryngologists should try to assess the extent of psychological factors associated with the patients' vertigo/dizziness. At the time of medical interviews, consistency of symptoms and signs as somatic disorders must be considered. After that, some questionnaires and mental tests are used. I always use the DHI (dizziness handicap inventory). Although this questionnaire is basically used for assessment of subjective impacts of dizziness/vertigo, it can reflect the psychological states of patients to some extent. The majority of patients with very high scores (DHI scores>80) had psychological problems. I recommend the POMS (profile of mood states) approach as a screening test of psychological problems because one can assess multiple factors associated with the patients' overall mental state. The SDS (self-rating depression scale) and the STAI (state-trait anxiety inventory) can be also used for assessment of depression and anxiety respectively. Although mental tests are useful for assessment of patients, one should not put too much faith on the results of a single mental test but assess patients comprehensively.