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ObjectivePeople with vestibular disorders frequently experience psychological distress which can impede daily activities and clinical recovery. Although the need for psychological input is widely acknowledged, there are no clinical guidelines, leading to variation in care received. This study examines how psychological aspects of vestibular disorders are currently addressed highlighting any national variation.MethodAn online survey was completed by 101 UK healthcare professionals who treat vestibular disorders. The survey included open and close-ended questions covering service configurations, respondent characteristics, attitudes towards psychological aspects, and clinical practice for cognitive and mental health problems. Results96% of respondents thought there was a psychological component to vestibular disorders. There was a discrepancy between perceived importance of addressing psychological aspects and confidence to undertake this. Those with more years of experience felt more confident addressing psychological aspects. Mental health problems were addressed more frequently than cognitive problems. History taking and questionnaires containing one or two items about psychological distress were the most common assessment approaches. Discussing symptoms and signposting were the most frequent management approaches. Referrals for psychological support were typically to professionals within another service, via the patient’s GP. Qualitative responses highlighted the interdependence of psychological and vestibular disorders which require identification and timely intervention. Barriers to implementation included limited referral pathways and interdisciplinary expertise.ConclusionClinical practice varies and relates to the confidence, experience and expertise of individual health professionals, resources, and appropriate referral pathways. Although psychological distress is frequently identified, suitable psychological treatment is not routinely offered in the UK.
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Smith et al. (2022) studied this question.