Background Vestibular schwannoma (VS) often results in persistent dizziness that negatively impacts quality of life (QoL). While physical effects are well-documented, the influence of psychological factors on dizziness severity is less studied. This study investigates how psychological characteristics affect dizziness in VS patients. Methods In this cross-sectional study, 93 VS patients were analyzed, with 77 (82.8%) reporting postoperative dizziness. Psychological factors, including premorbid disorders, personality traits, somatization, and current depression and anxiety levels, were assessed using self-report questionnaires. Correlations between these factors and dizziness severity, measured by the Dizziness Handicap Inventory (DHI), were examined. Results Patients with postoperative dizziness had higher depression levels and a greater prevalence of preoperative dizziness compared to those without postoperative dizziness. Significant correlations were found between dizziness severity and psychological factors: conscientiousness (r = .30, p = .03), social support (r = .32, p = .03), and the HADS total score (r = .36, p = .01). Emotional aspects of dizziness (DHI-E) were correlated with somatization (r = .27, p = .04) and anxiety (r = .40, p = .01). Functional aspects (DHI-F) were linked to conscientiousness (r = .31, p = .03) and depression (r = .26, p = .06). Conclusion Psychological factors significantly impact dizziness severity in VS patients. Incorporating psychological assessments and interventions, such as cognitive-behavioral therapy and combined vestibular and psychological rehabilitation, may improve treatment outcomes and QoL. Further research is needed to assess the effectiveness of these approaches and their impact on the relationship between psychological factors and dizziness

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Ethics Committee of University Hospital Halle (No. 2020-008).

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