Meniere's Disease Leads to a Significant
Decline in Quality of Life for Patients with Disorder
A University of California-San
Diego study highlights Meniere's disease's impact on physical and mental health
May 13-15, 2000
ORLANDO, FL -- Meniere's Disease is a chronic illness that often affects individuals
in the prime of life. Many believe the disorder has a serious impact on the
psychosocial status of individuals and their families. For the first time, a
new study quantifies health-related quality of life status of patients with
Meniere's disease who have failed conventional medical therapy and are candidates
for further intervention and compares their status with other medical disorders
described in a similar fashion.
Early studies suggested that there was a psychosomatic component in the etiology
of this disorder. Now, it is generally accepted that the psychological aspects
of the illness are in fact the consequence of the disease itself. A number of
studies have shown Meniere's disease is associated with anxiety, depression
and inability to concentrate.
The authors of the study, "Impact of Meniere's Disease on Quality of Life,"
are Jeffrey P. Harris, MD, PhD, from the Division of Otolaryngology-Head & Neck
Surgery, and John P. Anderson, PhD, Department of Family and Preventive Medicine,
at the University of California-San Diego. Their findings were presented before
the American Otologic Society, meeting May 13-15, in Orlando, FL.
Nineteen patients (12 female, seven male, age 32 to 83 yrs); all had been diagnosed
with Meniere's disease that had been resistant to medical therapy; the baseline
interviews on the subjects were performed by trained interviewers prior to any
Three instruments were used in the study:
Quality of Well-being Scale (QWB): A quantitative general health measure that
allows for comparison of all diseases or conditions. It permits an analysis
of programs, policies and treatments for the specified diseases and conditions,
and allows calculation of Quality-Adjusted Life Years gained or lost by affected
individuals. Patients are asked about their experience and dysfunction for each
of the past six consecutive days.
They are asked to define their symptom/problem complex - (headache, dizziness,
ringing in ears), using criteria such as mobility scale-e.g. limitations in
travel, physical activity scale-e.g. in bed, and social activity scale- e.g.
Medical Outcomes Study SF-12: Widely employed general health status measure.
This research tool rates physical and mental status by asking how often or how
troublesome described situations are either during the past week or ongoing.
Center for Epidemiologic Studies-Depression Scale (CES-D): This is a widely
used measure of psychological depression. Generally, 20 items rated on a scale
of 0-3 over the past week: zero (best) to 60 (worst). Scores 16 or above indicate
clinically significant depression).
The study revealed the following:
QWB scores: Meniere's disease patients achieved a mean score of .505 on days of acute
episodes and .620 on days without acute episodes. This compares with scores
of normal adults (.810), very ill adults with life-threatening illness (cancer,
AIDS (.616), non-institutionalized Alzheimer's patients (.506), and AIDS & cancer
patients, six days before death (.427). This indicates that Meniere's patients
lost 43.9% from
optimum well-being or .439 quality adjusted life years lost for each year in
their QWB state. This score reflects major impairment in mobility, physical
activity, social activity and clear thought processes.
CES-D scores: Meniere's patients registered a mean CES-D score of 23 (significant
depression 16 and above). This compares with trauma patients (CES-D 20), cochlear
implant candidates (CES-D 15), patients with post-cochlear implantation (CES-
D 12) .SF-12 scores:
Meniere's patients recorded scores SF-12 physical- 38.9 (mean 50, + 10) and
SF-12 mental- 44.2 ( mean 50, + 10). Meniere's disease patients are among the
most severely impaired non- hospitalized patients studied thus far. These patients
exhibit even more impairment on days with acute episodes. Patients describe
impairment in travel, ambulation, work and other major social roles as well
as trouble learning, remembering and thinking clearly. They are clinically depressed
as a group
The degree of impairment and depression which stems from this condition becomes
the responsibility of treating physicians to develop and offer treatment options
to their Meniere's patients. The authors call on the medical community and fellow
specialists to not condone a nihilistic approach to treatment, stress to primary
care colleagues that this condition requires treatment, and seek out effective
treatment strategies for this debilitating illness.
By Karin Henderson - Nurse, Retired.
Used with permission
This article was contributed by Millie at:
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