Jafri, Shabih

ABSTRACT Objective To derive precise estimates of anxiety and depressive disorder prevalence in patients with common vestibular disorders. Data Sources CINAHL, Cochrane Library, PubMed, PsycINFO, and SCOPUS. Review Methods This systematic review and meta‐analysis was reported per PRISMA guidelines. Outcomes included continuous measures (mean), proportions (%), and relative risks (RR) with 95% confidence intervals. Results Eighty‐five studies ( n = 764,403) examining anxiety, depression, and vestibular disorders in adults were included. Mean ages were 50.3 (vestibular) and 46.7 (control); females comprised 63.8% and 64.3%, respectively. Patients with vestibular disorders had significantly higher rates and risks of anxiety (31.4% vs. 8.3%, p < 0.0001; RR = 1.50, 95% CI: 1.1–2.0) and depression (28.3% vs. 4.7%, p < 0.0001; RR = 2.9, 95% CI: 1.8–4.4) than controls. Elevated rates were observed in benign paroxysmal positional vertigo (30.6%, 23.6%), Meniere's disease (47.0%, 43.1%), vestibular migraine (46.5%, 35.7%), and vestibular neuritis (19.4%, 20.7%) (all p < 0.0001). Episodic disorders showed higher prevalence than vestibular neuritis. Patients with unspecified peripheral vestibular disorders also had significantly higher anxiety (12.1%) and depression (13.2%) rates than controls. Meta‐regression revealed significant associations between Dizziness Handicap Inventory (DHI) scores and Hospital Anxiety and Depression Scale (HADS) anxiety and depression subscales. Conclusions This meta‐analysis offers the most precise prevalence and relative risk estimates of anxiety and depressive disorders in vestibular illness. The greater risk in episodic versus single‐event vestibular disorders may inform the understanding of vestibular–psychiatric comorbidity mechanisms.