眩晕疾病与焦虑抑郁状态相关性的研究进展
Advances in the Study of the Correlation between Vertigo Disorders and Anxiety-Depressive States
DOI: 10.12677/acm.2025.15102726, PDF,   
作者: 李晶晶, 王 婧, 张桂芳*:延安大学咸阳医院神经内科,陕西 咸阳
关键词: 眩晕焦虑抑郁共病Vertigo Anxiety Depression Co-Morbidity
摘要: 眩晕症是最常见的临床综合征之一,随人口老龄化进程加快,老年人群患病风险显著上升,且常与焦虑抑郁障碍共病。二者存在双向交互作用,不仅加重患者眩晕症状与情绪困扰,还增加疾病负担、影响预后。目前二者关联机制虽已逐步明晰,但不同病因眩晕与情绪障碍的复杂相互作用、基于生物标志物的精准诊疗工具研发及多模式治疗的长期疗效验证仍需深入探索,未来需通过多学科深度协作与技术创新,完善诊疗方案。
Abstract: Vertigo is one of the most common clinical syndromes, and with the aging of the population, the risk of the disease has increased significantly in the elderly population and is often co-morbid with anxiety and depression disorders. The two disorders interact in a bidirectional manner, not only aggravating vertigo symptoms and emotional distress, but also increasing the burden of disease and affecting prognosis. Although the mechanism of their association has been gradually clarified, the complex interactions between vertigo and mood disorders of different etiologies, the development of precise diagnostic tools based on biomarkers, and the validation of the long-term efficacy of multimodal treatments still need to be explored, and the future needs to be improved through in-depth multidisciplinary collaboration and technological innovation to improve the diagnostic and treatment programs.
文章引用:李晶晶, 王婧, 张桂芳. 眩晕疾病与焦虑抑郁状态相关性的研究进展[J]. 临床医学进展, 2025, 15(10): 61-68. https://doi.org/10.12677/acm.2025.15102726

参考文献

[1] 娄铮, 刘颖, 邵双阳, 等. 未分化性疾患(未分化疾病)的研究进展[J]. 全科医学临床与教育, 2021, 19(7): 636-639.
[2] Kerber, K.A., Callaghan, B.C., Telian, S.A., et al. (2017) Prevalence and Overlap of Dizziness Symptom Types: A Nationally Representative US Survey. The American Journal of Medicine, 130, 1465.E1-1465.e9.
[3] Kim, S.K., Kim, Y.B., Park, I.S., et al. (2016) Clinical Analysis of Patients with Dizziness Accompanied by High Depression and Anxiety. Journal of Hearing and Otology, 20, Article 174.
[4] Feng, S. and Zang, J. (2023) Impact of Comorbid Anxiety and Depression on Patients with Different Vestibular Syndromes. Frontiers in Aging Neuroscience, 15, Article 1208392.
[5] 韩英博, 彭俊阳, 姚建华. 眩晕的病因分类与规范诊治[J]. 中国老年学杂志, 2015, 35(9): 2590-2592.
[6] 孔维佳. 眩晕[M]//孔维佳. 耳鼻咽喉头颈外科学. 第3版. 北京: 人民卫生出版社, 2015: 190-202.
[7] Quimby, A.E., Kwok, E.S.H., Lelli, D., et al. (2018) Application of HINTS Examination and Neuroimaging in the Evaluation of Peripheral Vertigo in the Emergency Department. Journal of Otorhinolaryngology Head and Neck Surgery, 47, Article 54.
[8] Bisdorff, A., Von Brevern, M., Lempert, T. and Newman-Toker, D.E. (2009) Classification of Vestibular Symptoms: Towards an International Classification of Vestibular Disorders. Journal of Vestibular Research, 19, 1-13. [Google Scholar] [CrossRef] [PubMed]
[9] Hülse, R., Biesdorf, A., Hörmann, K., Stuck, B., Erhart, M., Hülse, M., et al. (2019) Peripheral Vestibular Disorders: An Epidemiologic Survey in 70 Million Individuals. Otology & Neurotology, 40, 88-95. [Google Scholar] [CrossRef] [PubMed]
[10] 刘旭辉, 冯亚群, 郑常龙. 老年人眩晕的流行病学调查与相关因素分析[J]. 临床医学工程, 2013, 20(7): 895-896.
[11] Muelleman, T., Shew, M., Subbarayan, R., et al. (2017) Epidemiology of Dizziness in a Neurology Outpatient Population and Predictive Factors for Peripheral Causes. Otology & Neurotology, 38, 870-875.
[12] Formeister, E.J., Rizk, H.G., Kohn, M.A., et al. (2018) Epidemiological Study of Vestibular Migraine: A Population-based Survey Research. Otology & Neurology, 39, 1037-1044.
[13] 单希征, 石丽亚, 王恩彤, 等. 6056例住院眩晕病例的临床流行病学分析[J]. 北京医学, 2019, 41(1): 46-51.
[14] de Joode, L.E.G.H., Martin, E.C., Stultiens, J.J.A., Leue, C., Delespaul, P., Peeters, F., et al. (2020) The Dizzyquest: To Have or Not to Have… a Vertigo Attack? Journal of Neurology, 267, 15-23. [Google Scholar] [CrossRef] [PubMed]
[15] Bandelow, B. and Michaelis, S. (2015) Epidemiology of Anxiety Disorders in the 21st Century. Dialogues in Clinical Neuroscience, 17, 327-335. [Google Scholar] [CrossRef
[16] 肖茜, 张道龙. ICD-11与DSM-5关于焦虑障碍诊断标准的异同[J]. 四川精神卫生, 2020, 33(1): 79-83.
[17] Malhi, G.S. and Mann, J.J. (2018) Depression. The Lancet, 392, 2299-2312. [Google Scholar] [CrossRef] [PubMed]
[18] Prell, T. and Axer, H. (2022) A Prospective Observational Study on Avoidance Behaviors in Patients with Chronic Dizziness. Journal of Clinical Medicine, 11, Article 7473.
[19] Hilber, P. (2022) The Role of the Cerebellar and Vestibular Networks in Anxiety Disorders and Depression: The Internal Model Hypothesis. The Cerebellum, 21, 791-800. [Google Scholar] [CrossRef] [PubMed]
[20] 王依倩, 袁春雨, 武继敏, 等. 前庭系统与情绪障碍之间联系的研究进展[J]. 听力学及言语疾病杂志, 2021, 29(5): 572-575.
[21] McCall, J.G., Al-Hasani, R., Siuda, E.R., et al. (2015) CRH Is Involved in the Locus Coeruleus Noradrenergic System Mediating Stress-Induced Anxiety. Neuron, 87, 605-620.
[22] Raver, C., Uddin, O., Ji, Y., et al. (2020) The Amygdala-Parabrachial Pathway Modulates Pain Perception and Chronic Pain. The Journal of Neuroscience, 40, 3424-3442.
[23] Fu, W., Le Maître, E., Fabre, V., Bernard, J., David Xu, Z. and Hökfelt, T. (2010) Chemical Neuroanatomy of the Dorsal Raphe Nucleus and Adjacent Structures of the Mouse Brain. Journal of Comparative Neurology, 518, 3464-3494. [Google Scholar] [CrossRef] [PubMed]
[24] Best, C., Tschan, R., Eckhardt-Henn, A., et al. (2009) Who Is at Risk of Persistent Dizziness and Psychological Distress after Vestibular Disease? Neuroscience, 164, 1579-1587.
[25] 蒋黎娜, 于倩如, 于杰, 等. 前庭性眩晕疾病患者焦虑和抑郁状况研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 1-5.
[26] 王建兵, 罗凝春, 周驽, 等. 老年前庭周围性眩晕与睡眠障碍的相关性研究: 基于匹兹堡睡眠质量指数评分的横断面分析[J]. 老年医学与保健, 2025, 31(2): 400-403+408.
[27] Chen, Z.J., Zhang, C.H., Hu, L.Y., et al. (2016) Increased Risk of Benign Paroxysmal Positional Vertigo in Patients with Anxiety Disorders: A Nationwide Population-Based Retrospective Cohort Study. BMC Psychiatry, 16, Article No. 238.
[28] Jacobson, G.P. and Newman, C.W. (1990) The Development of the Dizziness Handicap Inventory. Archives of OtolaryngologyHead and Neck Surgery, 116, 424-427. [Google Scholar] [CrossRef] [PubMed]
[29] Kalin, N.H. (2020) Novel Insights into Pathological Anxiety and Anxiety-Related Disorders. American Journal of Psychiatry, 177, 187-189. [Google Scholar] [CrossRef] [PubMed]
[30] Li, J.O., Li, E.S., Kim, J.S., et al. (2018) Altered Brain Function in Persistent Postural-Perceptual Dizziness: A Resting-State Functional Connectivity Study. Human Brain Mapping, 39, 3340-3353.
[31] Kangas, E.S., Vuoriainen, E., Lindeman, S. and Astikainen, P. (2022) Auditory Event-Related Potentials in Separating Patients with Depressive Disorders and Non-Depressed Controls: A Narrative Review. International Journal of Psychophysiology, 179, 119-142. [Google Scholar] [CrossRef] [PubMed]
[32] Cai, H., Han, J., Chen, Y., et al. (2018) Universal Method for Depression Detection Based on Electroencephalogram. Complexity, 2018, Article 5238028.
[33] 程韵洲, 段明. 换个角度看多学科联合诊疗[J]. 中国社区医师, 2016, 32(22): 133+135.
[34] Rodriguez, A.I., Zupancic, S., Song, M.M., Cordero, J., Nguyen, T.Q. and Seifert, C. (2017) Importance of an Interprofessional Team Approach in Achieving Improved Management of the Dizzy Patient. Journal of the American Academy of Audiology, 28, 177-186. [Google Scholar] [CrossRef] [PubMed]
[35] Whitney, S.L., Sparto, P.J. and Furman, J.M. (2020) Vestibular Rehabilitation and Factors That Can Affect Outcome. Seminars in Neurology, 40, 165-172. [Google Scholar] [CrossRef] [PubMed]
[36] 张丽芳, 邢思思, 张淑媛. 中医综合疗法对于伴发焦虑抑郁良性阵发性位置性眩晕的疗效分析[J]. 时珍国医国药, 2024, 35(9): 2211-2213.
[37] 袁天懿, 曹效平, 查曹兵. 慢性主观性头晕的发病机制及治疗进展[J]. 医药导报, 2017, 36(9): 1015-1020.
[38] 王璐, 巫玉娟, 张永义, 等. 前庭康复在眩晕疾病治疗中的应用研究[J]. 临床医药文献电子杂志, 2019, 6(31): 64.
[39] Waterston, J., Chen, L., Mahony, K., Gencarelli, J. and Stuart, G. (2021) Persistent Postural-Perceptual Dizziness: Precipitating Conditions, Co-Morbidities and Treatment with Cognitive Behavioral Therapy. Frontiers in Neurology, 12, Article 795516. [Google Scholar] [CrossRef] [PubMed]
[40] 王侠, 王家蔚, 邢锋. 行为认知疗法对抑郁伴焦虑患者的效果[J]. 国际精神病学杂志, 2025, 52(1): 106-109.
[41] Axer, H., Finn, S., Wassermann, A., Guntinas-Lichius, O., Klingner, C.M. and Witte, O.W. (2020) Multimodal treatment of Persistent Postural-Perceptual Dizziness. Brain and Behavior, 10, e01864. [Google Scholar] [CrossRef] [PubMed]
[42] Teh, C.S., Abdullah, N.A., Kamaruddin, N.R., Mohd Judi, K.B., Fadzilah, I., Zainun, Z., et al. (2022) Home-Based Vestibular Rehabilitation: A Feasible and Effective Therapy for Persistent Postural Perceptual Dizziness (A Pilot Study). Annals of Otology, Rhinology & Laryngology, 132, 566-577. [Google Scholar] [CrossRef] [PubMed]
[43] 贾安红, 杨丽娟. 积极共情反馈式心理护理对焦虑症患者情绪状态及恢复效果的影响[J]. 国际护理学杂志, 2023, 42(13): 2359-2362.
[44] 邓友梅, 莫妙霞, 凌瀚, 等. 焦虑症患者采用心理护理结合生物反馈进行治疗的临床疗效[J]. 中国医药科学, 2020, 10(16): 242-244+248.
[45] Wu, C.L., Lu, T.H., Zhang, W.H., et al. (2025) The Role of the Insula in the rTMS Response in Depression. Journal of Affective Disorders, 370, 538-546. [Google Scholar] [CrossRef] [PubMed]
[46] 林晨珏, 席淑新, 王璟. 前庭康复训练对前庭外周性眩晕患者眩晕残障症状的改善作用[J]. 中华医学杂志, 2020, 100(32): 2503-2506.
[47] Soberg, H.L., Andelic, N., Langhammer, B., et al. (2021) Impact of Vestibular Rehabilitation on Changes in Health-Related Quality of Life in Patients with Dizziness and Balance Problems after Traumatic Brain Injury: A Randomized Controlled Trial. Journal of Rehabilitation Medicine, 53, Article 2781.