Vertigo may be accompanied by psychological factors, either as a cause and/or an effect. This relationship is sometimes complex and may not be immediately apparent at first glance, particularly when the vertigo itself takes centre stage. Understanding the psychological implications is essential for an appropriate resolution of the problem, and the systematisation of certain conditions is helpful, but we are far from being able to generalise about the importance of psychological factors and cause-and-effect relationships, both because we have little knowledge to shed light on these issues – particularly regarding the mechanisms underlying this relationship between vertigo and psychopathology – and because of the complexity of the factors involved.