Dizziness Directly Influences Postconcussion Symptoms and Is Predictive of Poorer Mental Health in UK Military Personnel: A Retrospective Analysis.

OBJECTIVE

To investigate the contribution of dizziness to postconcussion symptoms, depression, and anxiety symptoms.

SETTING

Mild traumatic brain injury (mTBI) service, Defence Medical Rehabilitation Centre, Stanford Hall.

PARTICIPANTS

Two hundred eighty-three UK military personnel from the Royal Navy, Royal Airforce, Royal Marines, and British Army.

DESIGN

A retrospective analysis of data from the Ministry of Defence medical records database.

MAIN MEASURES: Sixteen-item Rivermead Post Concussion Symptoms Questionnaire, Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire-9, The Dizziness Handicap Inventory.

RESULTS

Injuries from sports or falls were the most common mechanism of mTBI, accounting for 23%, respectively. Chi-square analysis indicated that individuals with dizziness and postconcussion symptoms (PCS) had greater severity of PCS, depression, and anxiety than those with PCS alone. Mediation analysis showed dizziness directly and independently influenced the severity of PCS, despite the indirect effects of mediating depression and anxiety symptoms.

CONCLUSION

Comorbid dizziness and PCS were predictive of poorer mental health compared with PCS alone. In addition, dizziness directly influenced the severity of PCS irrespective of the indirect effects of mental health symptoms. These observations suggest that treating dizziness with vestibular rehabilitation may improve PCS and mental health.