Diet-Related Quality of Life in Patients with Dizziness and Balance Disorders: Associations with Psychological Distress, Autonomic Dysfunction, and Migraine

Background/Objectives: This study aimed to examine the associations between diet-related quality of life (DRQOL) and psychological distress, autonomic dysfunction, and migraine in patients with dizziness and balance disorders. Methods: In this retrospective cross-sectional study, 122 patients (56 men, 66 women; mean age 40.4 ± 12.8 years, minimum 14, maximum 65) from the vertigo outpatient clinic at JR Tokyo General Hospital completed self-reported questionnaires. These included the DRQOL scale, Dizziness Handicap Inventory (DHI), Hospital Anxiety and Depression Scale (HADS), Self-rating Depression Scale (SDS), Orthostatic Dysregulation (OD) checklist, and migraine assessments (POUNDing [Pulsating, duration of 4–72 h, Unilateral, Nausea, Disabling], MIDAS, migraine screener). Correlational analyses, group comparisons, and receiver operating characteristic (ROC) analyses were conducted. Results: DRQOL scores showed positive correlations with psychological distress (SDS: ρ = 0.58; HADS-A: ρ = 0.50; HADS-D: ρ = 0.52; all p <  0.001) and OD severity (ρ = 0.48, p <  0.001), but not with age, DHI, or individual migraine indices. Migraine screener-positive patients had significantly higher DRQOL scores (p <  0.01). DRQOL alone modestly discriminated positive migraine screener (AUC = 0.65), improving to AUC = 0.77 in a multivariable model including age and sex. Conclusions: DRQOL can capture psychological and autonomic symptom burden rather than vestibular or headache severity, suggesting that it may serve as a complementary, patient-centered metric in the holistic assessment of dizziness patients.