Objectives The aims of this study are to assess the differences of depression and anxiety in cervical spondylotic axial neck pain (CSAP) patients with and without vertigo.Method A total of 1404 consecutive CSAP patients were interviewed and asked to complete questionnaires in order to assess psychiatric symptoms during the period between January 2009 and January 2016 from our orthopedic clinic.The CSAP was diagnosed from both axial neck pain and radiological evidence of disc degeneration in cervical spine,and cervical radiculopathy and cervical myelopathy were excluded.All the 1404 patients were divided into two groups according to vertigo status.Neck pain was assessed with the Visual Analog Scale (VAS);anxiety and depression were assessed with the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS).Results Rates of anxiety and depression in CSAP vertigo patients were considerably higher than those in CSAP non-vertigo patients.This difference was notable in CSAP vertigo patients,reaching 51.3% and 55.9%,compared with 24.6% and 29.0% for CSAP non-vertigo patients,as measured by the SAS and SDS,respectively (P < 0.05).Conclusions Our findings suggest that rates of anxiety and depression are higher among the CSAP vertigo patients than the CSAP non-vertigo patients.