Abstract: Objective To evaluate the level of disease burden in patients with vestibular migraine and to investigate its association with psychiatric comorbidities, thereby providing a basis for the formulation of individualized treatment strategies. Methods A total of 388 patients diagnosed with vestibular migraine were recruited from a specialized vestibular clinic between October 2024 and April 2025 to form the case group. Concurrently, 388 patients with typical migraine without vestibular symptoms were enrolled as the control group. General demographic data and clinical characteristics were compared between the two groups. Patient assessments were conducted using the Migraine Disability Assessment (MIDAS), the Generalized Anxiety Disorder-7 (GAD-7) scale, the Patient Health Questionnaire-9 (PHQ-9), and the Migraine-Specific Quality of Life Questionnaire (MSQOL). Patients in the case group also completed the Dizziness Handicap Inventory (DHI). The study analyzed the exacerbation of disease burden in vestibular migraine and its relationship with psychiatric comorbidities. Results Of the 388 vestibular migraine patients, 13 were excluded due to invalid questionnaires, resulting in a final case group of 375 participants. Among the 388 patients with typical migraine, 18 were excluded due to invalid questionnaires or voluntary withdrawal, yielding a final control group of 370 participants. Multivariate logistic regression analysis revealed that attack frequency (OR=6.129) and MSQOL score (OR=0.543) were significant influencing factors for anxiety alone in patients with vestibular migraine (all P<0.05). Similarly, attack frequency (OR=5.249) and MSQOL score (OR=0.576) were identified as significant factors for depression alone (all P<0.05). The influencing factors for comorbid anxiety and depression in this population were age (OR=8.232), gender (OR=6.571), attack frequency (OR=9.952), MIDAS score (OR=5.796), DHI score (moderate disability OR=9.138, severe disability OR=11.816), direct medical expenditure (OR=1.002), and MSQOL score (OR=0.421) (all P<0.05). Psychiatric comorbidities were found to exert a partial mediating effect on the relationship between disease burden and quality of life, accounting for 20.00% of the total effect. Conclusion This study indicates that factors such as attack frequency and quality of life are significantly associated with psychiatric comorbidities in patients with vestibular migraine. Furthermore, psychiatric comorbidities partially mediate the relationship between disease burden and quality of life, providing a crucial evidence base for the development of personalized therapeutic approaches.

Key words: Vestibular migraine, Disease burden, Anxiety, Depression, Quality of life, Psychosomatic comorbidity