A Case of Phobic Postural Vertigo Caused by Obsessive Thoughts and Psychological Distress, in the Indian Subcontinent

Abstract

Dizziness is one of the most common symptoms in primary care and can be associated with otologic, neurologic, and psychiatric conditions, (Furman & Jacob, 2001). Phobic postural vertigo is a term used to define a population with dizziness and avoidance behaviour often as a consequence of a vestibular disorder, (Holmberg et al., 2006). It is characterised by a combination of non-rotational vertigo with subjective postural and gait instability, mainly in patients with an obsessive-compulsive personality, (Brandt, T., Huppert, D. & Dieterich, M., 1994). In this paper, we present a case of Phobic Postural Vertigo (PPV) caused by obsessive thoughts and psychological distress with primary gain as a motivating and maintaining factor. G, a 32-year-old male presented with complaints of panic symptoms, headache, physical weakness, and lack of self-esteem with a history of obsessive traits and was diagnosed with PPV after no clinical vestibular abnormalities were found by the otolaryngology department. Currently, the patient is on medication for his obsessive features, and an eclectic therapeutic intervention plan which includes cognitive behavioural therapy as the anchor and goals for the patient’s treatment are discussed.