The association between vestibular-related symptoms and depressive symptoms: a systematic review and meta-analysis

Abstract

Abstract Introduction Vestibular-related symptoms are increasingly recognized as being significantly associated with depressive symptoms, yet the strength and consistency of this association remain unclear due to conflicting evidence across studies. It is also uncertain whether this relationship reflects general psychological distress or is specific to clinically significant depressive symptoms. Objective To conduct the first systematic review and meta-analysis examining the strength and consistency of the association between various vestibular-related symptoms and depressive symptoms. Methods We systematically searched PubMed, Embase, Web of Science, ScienceDirect, PsycINFO, and EBSCOhost from inception to August 2025. Observational studies assessing vestibular-related symptoms and depressive symptoms using validated tools were included. Data were pooled using random-effects models to estimate correlation coefficients (r). Heterogeneity was quantified with I², and subgroup analyses, sensitivity analyses, and publication bias assessments were performed. Results Twenty-four studies involving 4067 participants were included. Meta-analysis revealed a statistically significant positive correlation of moderate magnitude between vestibular-related symptoms and depressive symptoms (r = 0.44, 95% CI: 0.38-0.50, p < 0.001), with high heterogeneity (I² = 80.9%). Subgroup analyses confirmed consistent correlations across vestibular disorder subtypes (chronic: r = 0.45; episodic: r = 0.45; mixed: r = 0.43) and depressive symptom assessment instruments. Sensitivity analyses supported result robustness, and no significant publication bias was detected. Conclusion Vestibular-related symptoms demonstrate a significant association with depressive symptoms that persists across disease subtypes and assessment methods. The magnitude of the association should be interpreted cautiously because of substantial between-study heterogeneity. These findings highlight the need for integrated clinical management that addresses both conditions. Future prospective studies are warranted to clarify temporal sequencing and potential mechanisms underlying this association.

The authors' abstract, as published at the source. Translational Psychiatry, 2026 · DOI ↗