Efficacy of Cognitive Behaviour Therapy for the Management of Chronic Subjective Dizziness: A Systematic Review

Abstract

Chronic Subjective Dizziness (CSD) is a persistent, non-vertiginous sensation of imbalance or motion, often described as a distorted or false sense of movement. It is frequently accompanied by a disruption in spatial orientation and heightened visual dependence, leading to significant distress. While dizziness itself can substantially affect daily functioning, the burden is further intensified when it co-occurs with psychiatric conditions such as anxiety disorders, depression, or somatization. This comorbidity results in greater psychosocial impairment and reduced quality of life than either condition would cause independently. CSD is particularly prevalent among older adults and is associated with additional complications, including increased risk of falls, social withdrawal, sleep disturbances, and chronic fatigue. The aim of this study is to evaluate the efficacy of Cognitive Behaviour Therapy (CBT) in managing chronic subjective dizziness through a systematic review. An extensive literature search was conducted across multiple databases, yielding 883 articles. After applying inclusion and exclusion criteria, eight studies were deemed suitable for analysis. The methodological quality and risk of bias in each study were assessed using the Newcastle-Ottawa Scale (NOS). Most of the selected studies employed retrospective, prospective, or experimental designs and were found to have a generally low risk of bias. This review highlights the clinical relevance of CBT, either as a standalone approach or in combination with non-pharmacological interventions such as vestibular rehabilitation exercises and medical management, in effectively treating chronic subjective dizziness. The findings support the incorporation of CBT into multidisciplinary treatment plans for patients with persistent dizziness symptoms.