Diet-Related Quality of Life Reflects Psychological and Autonomic Burden in Patients with Dizziness and Balance Disorders: A Cross-Sectional Study

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: Higher DRQOL scores indicate poorer DRQOL. DRQOL scores showed positive correlations with psychological distress (SDS: ρ = 0.57; HADS-A: ρ = 0.50; HADS-D: ρ = 0.53; all p < 0.001) and OD severity (ρ = 0.50, 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 showed modest ability to discriminate migraine screener-positive from migraine screener-negative patients (AUC = 0.65); discrimination improved to an AUC of 0.77 in a multivariable model that also included age and sex. Conclusions: DRQOL appears to capture psychological and autonomic symptom burden rather than vestibular or headache severity, suggesting that it may serve as a complementary, patient-centered metric that adds a multidimensional perspective to conventional vestibular and headache assessments.