Anxiety- and depression-related somatic symptoms and atlantoaxial disorders: potential mechanistic links and clinical implications

Anxiety and depressive disorders often include pain, dizziness, headache, fatigue, nausea, and sleep disturbance. These symptoms may also occur in atlantoaxial disorders, but overlap does not establish a shared cause. OBJECTIVE: To examine whether clinical or mechanistic evidence supports an association between objectively defined atlantoaxial disorders and somatic symptom burden in people with anxiety or...

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Audiologists and vestibular specialists encountering patients with unexplained dizziness alongside psychiatric symptoms should be aware of a possible atlantoaxial (upper cervical spine) contribution, but evidence is currently insufficient to recommend any specific diagnostic or treatment protocol change.

If atlantoaxial instability proves to be an underdiagnosed driver of somatic symptoms like dizziness in psychiatric patients, it could open an interdisciplinary pathway for audiologists, vestibular specialists, and psychiatrists to collaborate on complex cases.

1. 01Review explores mechanistic links between anxiety/depression somatic symptoms (dizziness, headache) and atlantoaxial disorders.
2. 02Dizziness is a shared symptom of both psychiatric conditions and upper cervical spine dysfunction.
3. 03Potential mechanisms proposed include brainstem compression and autonomic dysregulation.
4. 04Clinical implications are speculative at this stage — no controlled trials are cited as proof.
5. 05Published in Frontiers in Psychiatry.

PMID

42755440

DOI

10.3389/fpsyt.2026.1919035.

Journal

Frontiers in Psychiatry

Publication type

review

Evidence level

5

Population

Patients with anxiety- and depression-related somatic symptoms and/or atlantoaxial disorders as represented in reviewed literature

Intervention

Evaluation of atlantoaxial disorders as a potential contributor to somatic psychiatric symptoms