The VSS-lv includes 34 items that were created on the basis of patient interviews. There are two versions of the VSS: the long version (VSS-lv) and the short form (VSS-sf). The VSS has the highest comprehensive validity of the self-rated scales assessing vertigo- or dizziness-related symptoms. The VSS, which assesses patient-reported symptoms, has an advantage over the DHI in that it is not just used to evaluate the frequency of vestibular-balance symptoms, but also the severity of autonomic-anxiety symptoms, which have a great impact on quality of life. The DHI evaluates handicaps due to dizziness in daily life. Two patient-reported scales have been widely used to comprehensively evaluate patients with vestibular-balance symptoms: the Dizziness Handicap Inventory (DHI) and the Vertigo Symptom Scale (VSS).
Patient-reported scales assessing both vestibular-balance and psycho-physiological factors are absolutely necessary to evaluate severity of symptoms or effectiveness of treatment, such as vestibular rehabilitation and cognitive behavioral therapy.
Therefore, the clinical state of patients with vestibular-balance symptoms cannot be completely evaluated with vestibular and balance function tests, such as caloric tests or posturography. Vestibular-balance symptoms are often accompanied and interact with psycho-physiological symptoms, especially anxiety, which may also have a great impact on patient’s quality of life. These often become chronic and can greatly impair daily living. Vestibular-balance symptoms, such as vertigo and dizziness, affect approximately 20% of the population. Further research using the VSS-short form should be required in other languages and populations. The VSS-short form can be used to evaluate vestibular-balance symptoms and autonomic-anxiety symptoms, as well as the duration of vestibular-balance symptoms. Thus, it was suggested that vestibular-balance symptoms can be analyzed separately according to symptom duration, which may reflect pathophysiological factors. The VSS-short form has a three-factor structure that was cross-culturally well-matched with previous data from the VSS-long version. Total score and subscale interclass correlation coefficients for test-retest reliability were acceptable, ranging from 0.867 to 0.897. We obtained high Cronbach’s α coefficients for the total score and subscales, ranging from 0.758 to 0.866. Regarding convergent and discriminant validity, all hypotheses were clearly supported. An exploratory factor analysis produced a three-factor structure: long-duration vestibular-balance symptoms, short-duration vestibular-balance symptoms, and autonomic-anxiety symptoms. Model-fitting for a two-subscale structure in a confirmatory factor analysis was poor. The total sample and retest sample consisted of 159 and 79 participants, respectively. Convergent and discriminant validity, internal consistency, and test-retest reliability were evaluated. We conducted a confirmatory factor analysis followed by an exploratory factor analysis.
The questionnaire was translated into Japanese and cross-culturally adapted. They also completed the VSS-short form a second time 1–3 days later. Participants completed the VSS-short form, the Dizziness Handicap Inventory, and the Hospital Anxiety and Depression Scale. We conducted a cross-sectional, multicenter, psychometric evaluation of patients with non-central dizziness or vertigo persisting for longer than 1 month. Here, we clarified the factor structure of the VSS-short form, and assessed the validity and reliability of the Japanese version of this tool. Despite frequent use, the factor structure of the VSS-short form has yet to be confirmed. A common assessment tool is the Vertigo Symptom Scale (VSS) -short form, which has two subscales: vestibular-balance and autonomic-anxiety. Dizziness or vertigo is associated with both vestibular-balance and psychological factors.
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