Psychotherapy for Chronic Dizziness: A Scoping Review.

Chronic dizziness is a frequent condition that substantially impairs quality of life (QoL), making psychotherapy a crucial intervention alongside physical therapies. However, the overall landscape of evidence regarding its application to diverse dizziness disorders remains unclear. This scoping review aimed to comprehensively map the existing research on this topic, providing an overview of its utilization, intervention methods, and evaluation measures to identify research gaps. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, we searched PubMed and CiNii Research for peer-reviewed articles published in English or Japanese. Eligible studies were those describing a psychotherapeutic intervention for patients with chronic dizziness lasting three months or longer, published up to September 30, 2023. A total of 644 records were screened, with 23 studies ultimately included for analysis. Our results indicate that the current evidence base is largely developmental. The most common study design was the case study (10/23 studies, 43.5%), with a median of seven participants. The median age of participants was 45.2 years, indicating a primary focus on adult populations. The predominant psychotherapeutic technique was cognitive behavioral therapy (16/23 studies, 69.6%), typically delivered individually, with a median of 6.5 sessions. While evaluations were often multifaceted, assessing domains such as dizziness symptoms, psychological state, QoL, and physical function, the outcome measures used were highly diverse and not standardized. The Dizziness Handicap Inventory (DHI) and the Hospital Anxiety and Depression Scale (HADS) were the most frequently used instruments. Although the included studies collectively suggest that psychotherapy is a promising intervention for improving symptoms of chronic dizziness, this review highlights several key limitations of the existing evidence base: (a) it consists primarily of small-scale case studies, with a lack of high-quality evidence; (b) the research focuses on adult populations, with a scarcity of studies targeting children or adolescents; (c) while group formats and combination therapies show potential, the research is too limited to draw firm conclusions; and (d) the outcome measures used are highly diverse and not standardized. Therefore, to advance the field, future research must prioritize conducting high-quality intervention studies, particularly large-scale RCTs, that utilize standardized outcome measures.