Does Catastrophizing Predict Response to Treatment in Patients With Vestibular Disorders? A Prospective Cohort Study

Objective: Determine levels of catastrophizing in patients with vestibular disorders and prospectively evaluate their relationship with patient-reported outcome measures.Study Design: Prospective cohort study.Setting: Tertiary care neurotology vestibular disorders clinic.Patients: Adult patients with various vestibular disorders.Interventions: Patients were given the Dizziness Handicap Inventory (DHI) and the Dizziness Catastrophizing Scale (DCS) at a baseline visit and follow-up visit after treatment.Main outcome measures: Correlation studies were used to determine the relationships between DHI and DCS. Multivariable linear regression was performed to determine the relationship between DCS and DHI change with treatment, accounting for demographic variables.Results: Forty-six subjects completed both the DHI and the DCS before and after treatment. Patients with higher baseline DCS scores had higher baseline DHI scores (p < 0.001). There was a significant improvement in both DHI score (p < 0.001) and DCS (p < 0.001) at follow-up. Patients who had reduction in DCS scores during were more likely to show reduction in DHI scores (p < 0.001). A subset of patients had a mindfulness-based stress reduction program included in their treatment. These patients had a greater reduction in both DCS and DHI scores at follow-up compared with those who received other treatments.Conclusions: Catastrophizing is associated with higher pretreatment DHI scores and worse treatment outcomes. Addressing dizziness catastrophizing may help improve vestibular outcomes.