Neuroticism and functional burden in chronic dizziness: A clinical cross-sectional observational study using the Eysenck Model and Dizziness Handicap Inventory

Abstract

Background Chronic dizziness is a multidimensional condition often influenced by psychological factors. Among these, personality traits such as neuroticism have been linked to heightened symptom perception and disability. However, few studies have systematically examined the relationship between neuroticism, functional burden, and diagnostic characteristics in a population with clinical dizziness. Objective To investigate the relationship between perceived dizziness-related handicap and neuroticism as a personality trait among patients referred to a multidisciplinary dizziness and balance clinic. Methods This observational study included 247 adult patients with persistent dizziness referred to a specialist clinic. Patients completed the Eysenck Personality Questionnaire (EPQ) and the Dizziness Handicap Inventory (DHI). Clinical data included diagnosis category, duration of symptoms, fall history, comorbidities, and consultation history. Statistical analyses included Spearman correlations, ANOVA, chi-square tests, cluster analysis, and multivariate linear regression. Results Neuroticism was significantly correlated with higher DHI scores (ρ = 0.39, p < 0.001) and a greater number of healthcare consultations (ρ = 0.19, p = 0.003). It was not associated with duration of symptoms or fall history. A chi-square test indicated a significant association between the neuroticism category and diagnosis category (χ 2 = 32.02, p = 0.043), with higher neuroticism observed in functional and central disorders. Cluster analysis revealed three psychological-clinical subgroups varying in emotional burden, functional disability, and comorbidity profiles. In regression modelling, neuroticism was the only significant predictor of DHI score ( p < 0.001), independent of diagnosis or symptom duration. Conclusion Personality domains, especially neuroticism, are strong predictors of perceived functional burden in patients with chronic dizziness. These findings underscore the importance of incorporating psychological assessment into the clinical evaluation to further facilitate tailored interventions for the management of dizziness. Personality profiling may help identify high-burden subgroups and guide individualized, multidisciplinary care strategies.