Panic Disorder in Patients With Vestibular Dysfunction: A Systematic Review and Meta-analysis.

Objective: To assess the prevalence of panic disorder (PD) among patients with vestibular dysfunction.

Databases reviewed: CINAHL, Cochrane Library, PubMed, PsycINFO, and SCOPUS.

Methods: Databases were searched from inception through August 2024. Observational studies on PD in adults with vestibular dysfunction were included. Studies of patients without a vestibular disorder diagnosis or vertigo arising from trauma or tumors were excluded. Primary outcome measures included continuous measures (mean), proportions (%), and relative risk (RR) with 95% confidence intervals (CI). Two authors extracted data and discrepancies were resolved with a third party. Level of evidence was evaluated using Oxford Centre for Evidence-Based Medicine criteria. Risk of bias was assessed with Risk Of Bias In Non-randomized Studies-of Exposure for cohort studies and Joanna Briggs Institute criteria for case-control and cross-sectional studies.

Results: Ten studies (n = 874) on PD and vestibular disorders were included. The mean age was 49.7 years for the vestibular group and 46.0 years for the control group. Although there were no significant differences in the prevalence of anxiety and depression, there was a significantly higher prevalence of PD (7.4% vs. 2.5%) in patients with vestibular dysfunction than the control population (p = 0.02). However, the risk of developing PD among patients with vestibular disorders was not significantly higher (RR = 1.9, 95% CI: 0.4-8.1) than the controls.

Conclusion: The prevalence of PD in patients with vestibular dysfunction is nearly three times higher than in people without vestibular dysfunction. This evidence suggests otolaryngologists treating this condition should consider screening for PD.