精神科医のめまい症状の認識と診療連携判断―耳鼻咽喉科と精神科の連携構築のためのアンケート調査―

抄録

Background: Collaboration between otolaryngologists and psychiatrists is essential in managing dizziness, especially when psychiatric comorbidity is suspected. However, the referral criteria and shared clinical understanding remain unclear. We surveyed psychiatrists to clarify their perspectives to facilitate interdisciplinary collaboration.

Methods: An anonymous questionnaire was distributed to 71 psychiatrists in Saitama City. The questionnaire items included the frequency of dizziness encountered in psychiatric outpatient settings, associated psychiatric diagnoses, referral indications to the department of otolaryngology, criteria for psychiatric consultation in otolaryngology patients, and awareness about Persistent Postural-Perceptual Dizziness (PPPD).

Results: A total of 23 psychiatrists (32.4%) responded to the questionnaire survey. Most had over 20 years of experience and worked mainly in outpatient settings. The questionnaire responses indicated that anxiety, mood, and bodily distress disorder were the psychiatric symptoms most commonly associated with dizziness. Referrals to otolaryngology were infrequent and mainly prompted by suspected peripheral vestibular disorders; 65% referred patients when no clear psychiatric pathology was identified. Conversely, over 80% of respondents recommended psychiatric consultation for otolaryngology outpatients with persistent insomnia, appetite loss or functional impairment despite minimal objective findings. Awareness of PPPD was limited among psychiatrists, with only 30% familiar with its diagnostic criteria or treatment.

Conclusion: Although psychiatrists frequently encounter patients complaining of dizziness, structured collaboration with otolaryngologists remains limited. Clarifying referral criteria and fostering shared clinical understanding may improve coordination between the two fields and the quality of dizziness care.