The effect of combined cognitive behavioral therapy and rehabilitation training on negative emotions of patients with vestibular dysfunction: a real-world cohort study

Abstract

Purpose This study evaluated the association of combined cognitive behavioral therapy (CBT) and rehabilitation training with improvements in vestibular dysfunction and negative emotions based on real-world clinical practice. Methods This single-center, real-world, retrospective cohort study recruited 100 patients with vestibular dysfunction and negative emotions from a tertiary hospital in China between August 2020 and October 2024. Patients were divided into two groups based on actual treatment received: the conventional care group (n = 50) received standard medication and health education, while the combined intervention group (n = 50) additionally underwent a 3-month program of CBT combined with rehabilitation training. Primary outcomes included Visual Analog Scale (VAS), Dizziness Handicap Inventory (DHI), and Somatic Symptom Scale (SSS) scores at 3 months. Secondary outcomes included the above scales at 1 month, along with Generalized Anxiety Disorder Scale-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scores. Results At 3 months, the combined intervention group showed significantly greater improvement in VAS, DHI, and SSS scores compared to the conventional care group (all p < 0.05). At 1 month, the combined group demonstrated early superiority in the emotional and functional dimensions of the DHI. GAD-7 and PHQ-9 scores showed significantly greater psychological improvement in the combined group at both 1 and 3 months (p < 0.01). Conclusion In real-world settings, CBT combined with rehabilitation training was associated with greater improvements in dizziness, somatic symptoms, and anxiety/depression in vestibular dysfunction patients with negative emotions compared with conventional care. Most outcomes improved early, whereas the physical component of dizziness-related disability showed a later between-group separation, which supports the potential value of integrated psychosomatic care models.