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While vestibular outcomes are well studied, the contribution of psychological factors to persistent dizziness remains insufficiently understood. This cross-sectional study included 93 patients with VS, of whom 80.6% reported postoperative dizziness. Psychological factors were assessed using validated self-report questionnaires covering premorbid mental health conditions, personality traits, somatization, anxiety, depression, and psychological distress. Dizziness-related impairment was quantified using the Dizziness Handicap Inventory (DHI). Associations were examined using Spearman correlations with bootstrap resampling, followed by multivariable linear regression to identify independent predictors of dizziness handicap. Dizziness handicap was robustly associated with vestibular symptom burden, somatization, anxiety, and psychological distress. Higher anxiety and somatization scores were consistently related to greater dizziness-related impairment, particularly in emotional and functional domains. Higher scores on the GBI Social Support subscale, reflecting surgery-related changes in the need for and reliance on social support rather than baseline social support resources, were associated with greater dizziness handicap and independently predicted higher DHI scores. Personality traits showed heterogeneous associations; conscientiousness was positively associated with physical dizziness handicap and showed a trend-level association with overall handicap, potentially reflecting increased symptom monitoring or health awareness. Given the cross-sectional design and absence of objective vestibular testing, causal relationships cannot be established. Persistent dizziness after VS surgery likely reflects multifactorial mechanisms involving vestibular, psychological, and functional contributors. Future longitudinal studies integrating comprehensive neuro-otological assessments are needed to clarify temporal relationships and underlying mechanisms.<\/jats:p>","DOI":"10.1038\/s41598-026-64384-0","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T09:26:15Z","timestamp":1785317175000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Subjective persistent dizziness handicap and psychological factors in vestibular schwannoma patients: a cross-sectional study"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2122-6661","authenticated-orcid":false,"given":"M.","family":"Rutenkr\u00f6ger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Scheer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Rampp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Strauss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Sch\u00f6nfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Leplow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"issue":"12","key":"64384_CR1","doi-asserted-by":"publisher","first-page":"2784","DOI":"10.1002\/lary.25402","volume":"125","author":"A Batuecas-Caletrio","year":"2015","unstructured":"Batuecas-Caletrio, A., Santa Cruz-Ruiz, S., Mu\u00f1oz-Herrera, A. & Perez-Fernandez, N. 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