Objective To assess the efficacy of combining vestibular rehabilitation with cognitive behavioral therapy in treating chronic subjective dizziness ( CSD) and the associated anxiety. Methods A total of 98 anxious CSD patients were randomly divided into an experimental group ( n=50) and a control group ( n=48) . All of the pa-tients′scores on the Hamilton anxiety scale ( HAMA) were no less than 14 and their scores on the Hamilton depres-sion scale ( HAMD) were less than 18. Systematic vestibular rehabilitation was given to the patients in the control group, while this was combined with cognitive behavioral therapy for the patients in the experimental group. All pa-tients were evaluated using a dizziness handicap inventory ( DHI) and the HAMA before treatment and in the 4th and 8th week of the treatment. Results Before the treatment there was no significant difference between the 2 groups in any of the assessments. After 3 weeks of treatment, the average HAMA score, DHI total score and its factor scores had decreased significantly. Four weeks later, the average HAMA score, DHI total score and its factor scores for som-atization, emotion and function had improved significantly in both groups compared with before treatment and the scores after 3 weeks. After 3 and 7 weeks of treatment, the average HAMA score, DHI total score and its factor scores of the experimental group were significantly lower than those of the control group. Conclusion Cognitive behavioral therapy amplifies the effects of vestibular rehabilitation in treating persons with CSD, in part by significantly relieving their anxiety.

Objective To investigate the clinical efficacy and safety of escitalopram in the treatment of chronic subjec-tive dizziness ( CSD) . Methods A total of 90 CSD patients randomly divided into medication group ( n=32) ,vestibular reha-bilitation group (n=27) and psychological intervention group (n=31).Patients in the medication group treated with escitalopram (10-20 mg?d-1,PO),those in the vestibular rehabilitation group were underwent vestibular rehabilitation training and those in the psychological intervention group were given cognitive behavioral therapy. The treatment course lasted six weeks. All patients were evaluated by zDHI,HAMA and HAMD before and after the treatments. Results The total scores of HAMA,HAMD,DHI and the respective factor scores of DHI were significantly decreased in each group after 6-week treatment when compared with those before the treatment (P<0.01).The total scores of DHI was (30.45±15.84) in medication group and (36.15±13.07) in vestibular rehabilitation group,the physical factor score was (10.06±4.49) in medication group and (10.23±4.64) in vestibular rehabilitation group,and the functional factor score was (10.71±5.95) in medication group and (11.23±5.03) in vestibular reha-bilitation group,respectively.There were no significant differences in the three indices between medication group and vestibular re-habilitation group.But they were significantly lower than those in psychological intervention group [(43.86±12.48),(14.43± 4.37),and (17.57±4.37) for total scores of DHI,physical factor scores and functional factor scores,respectively] (P<0.05,or P<0.01).The emotional factor scores of DHI were (9.68±5.68) and (11.86±4.74),HAMA scores (9.97±4.72) and (12.18± 4.16),HAMD scores (10.26±4.91) and (12.32±4.53) in medication group and psychological intervention group(P>0.05),re-spectively.They were significantly lower in the two groups than in vestibular rehabilitation group [ (14.69±4.76),(14.96±4.77) and (14.88±4.65) for the emotional factor score,HAMA score and HAMD score,respectively,P<0.05 for all]. Conclusion Escitalopram can improve the symptoms of CSD involving the body,emotion and function.The vestibular rehabilitation training and cognitive behavioral therapy have their respective advantages.