Tinnitus Patients: Etiologic, Audiologic and Psychological Profile

Journal Riphah College of Rehabilitation Sciences, 2024

Objectives: To determine the characteristics of tinnitus and its association with clinical and demographic variables including psychological health. Methodology: This cross-sectional study recruited 80 tinnitus cases from ENT outpatients of District Head Quarter Hospital Chakwal from over a period of 6 months from 1st Jan 2019 to 31st June, 2019, using convenience sampling. Sample included both genders, aged 18-75 years with tinnitus for at least three months. Tinnitus Handicap Inventory (THI) & Depression Anxiety and Stress Scale 21 (DASS-21) were used for data collection & analysis done using SPSS-version 20. Anova statistics & Pearsons correlation was determined for THI and DASS-21. Chi-square test was used to see any association with clinic-demographic variables. P<0.05 was considered significant. Results: Study revealed 30(37.5%) cases with mild, 20(25%) each with moderate and severe while least 4(5%) catastrophic tinnitus. Tinnitus severity was significant associated with gender (p=0.005), age (p=0.035), educational level (p=0.049), occupation (p=0.002), duration of tinnitus (p=0.038), site of tinnitus (P<0.001) and type of tinnitus sound (P=0.003). Duration of tinnitus was associated with anxiety (p=0.024), site of tinnitus was associated with THI (p=0.016), anxiety (p=0.021), stress (p<0.001) and depression (p=0.02) and total DASS-21 (p=0.005). A significant positive correlation was present between tinnitus handicap, Anxiety, stress, depression and DASS-21 total score (P<0.001). Conclusion: Mild tinnitus was most prevalent (37.5%) with Tinnitus severity having significant association with gender, age, educational level, occupation, duration of tinnitus, site of tinnitus, and type of tinnitus sound. Duration of tinnitus was also associated with anxiety while site of tinnitus has association with THI, anxiety, stress, depression and total DASS-21. Significant positive correlation is present between THI and Anxiety, stress, depression and DASS-21 total score.

Indian Journal of Otolaryngology and Head &amp; Neck Surgery, 2011

Tinnitus is a very common complain and affects 7% of population and has been associated with a range of physical and emotional disorders (Hallam et al. in Br J Clin Psychol 27:213-222, 1988). Hence to understand the distress caused by tinnitus and its relationship with the nature of tinnitus so as to suggest the appropriate treatment, there is the need to study the impact of tinnitus of a group of tinnitus sufferers. This study could be done on the basis of verbal description of tinnitus, Audiological measurement of tinnitus and psychological characteristics of tinnitus in terms of distress, anxiety, depression and disturbance of personality, to understand the impact of tinnitus on sufferers. Fifty adults in the age range of 18-60 years with subjective tinnitus with bilateral normal hearing or pure SNHL ranging from mild to moderately severe were selected. An audiological profile of each subject was prepared on the basis of brief case history of subject, otoscopic examination, pure tone audiometry, impedance audiometry, frequency (pitch) and intensity (loudness) of tinnitus. A psychometric profile was developed by using Tinnitus Reaction Questionnaire and Nature of Tinnitus Questionnaire. These questionnaires were translated and adopted in Hindi and Bengali language after appropriate standardization procedure. 60% reported that they do not have any idea regarding probable cause of their tinnitus. 74% subjects of this study reported that there is no fluctuation in the pitch of their tinnitus. However, 68% reported loudness of tinnitus is fluctuating. A weak co-relation has been seen between traditional audiological measures like pitch matching, loudness matching and subject's description of pitch and loudness of tinnitus. There was a significant correlation between the impact of tinnitus and disturbance of sleep caused by it with increase in depression and anger (0.483). However, no significant co-relation was seen between distressed caused by tinnitus and duration of tinnitus (-0.034). The multiple nature/ sounds of tinnitus had far more devastating effects or serious impact on 'tinnitus sufferers' than the single sound/ nature. Gender differences were also found among tinnitus sufferers while assessing the audiological and psychological measures of tinnitus. Female subjects also reported a higher level of emotional reaction with a mean of 35.9 to their tinnitus as compared to males with a mean of 31.7. Tinnitus has resulted in multifold effects/impacts on tinnitus sufferers where it has made them feel unhappy, tense, irritable, depressed, annoyed, distressed and frustrated. It has interfered with their enjoyment, their relaxation, their sleep, and forced them to avoid quiet environmental and social situations. These findings should further help in the overall management of the patient suffering from tinnitus.

The Lancet Neurology, 2013

Tinnitus is the perception of sound in the absence of a corresponding external acoustic stimulus. With prevalence ranging from 10% to 15%, tinnitus is a common disorder. Many people habituate to the phantom sound, but tinnitus severely impairs quality of life of about 1-2% of all people. Tinnitus has traditionally been regarded as an otological disorder, but advances in neuroimaging methods and development of animal models have increasingly shifted the perspective towards its neuronal correlates. Increased neuronal fi ring rate, enhanced neuronal synchrony, and changes in the tonotopic organisation are recorded in central auditory pathways in reaction to deprived auditory input and represent-together with changes in non-auditory brain areas-the neuronal correlate of tinnitus. Assessment of patients includes a detailed case history, measurement of hearing function, quantifi cation of tinnitus severity, and identifi cation of causal factors, associated symptoms, and comorbidities. Most widely used treatments for tinnitus involve counselling, and best evidence is available for cognitive behavioural therapy. New pathophysiological insights have prompted the development of innovative brain-based treatment approaches to directly target the neuronal correlates of tinnitus. Lancet Neurol 2013; 12: 920-30 Department of Psychiatry and Psychotherapy (B Langguth MD, P M Kreuzer MD) and Interdisciplinary Tinnitus Center (B Langguth, P M Kreuzer, References 1 Krog NH, Engdahl B, Tambs K. The association between tinnitus and mental health in a general population sample: results from the HUNT Study. J Psychosom Res 2010; 69: 289-98. 2 Axelsson A, Ringdahl A. Tinnitus-a study of its prevalence and characteristics. Br J Audiol 1989; 23: 53-62. 3 Pilgram R. Tinnitus in der BRD. HNO aktuell 1999; 7: 261-65. 4 Shargorodsky J, Curhan GC, Farwell WR. Prevalence and characteristics of tinnitus among US adults. Am J Med 2010;

Progress in Brain Research, 2021

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Journal of Otolaryngology-ENT Research, 2017

Aim: This Article summarizes the Clinical Study of Tinnitus conducted in Government ENT Hospital, Koti and Hyderabad over a Period of two years. Objective: To describe the results found in a group of people who have undergone treatment with various medical treatments using carvoverine, Ginkgo Biloba, Multivitamin. Method: Using Tchqs Score 90 adult subjects with complaint of tinnitus and associated symptoms were analysed with Proper History, Clincal Examination and Pure Tone Audiometry and Thcq's to determine the Degree of Annoyance of the Tinnitus and to Assess Tinnitus Impact on the Quality of Life before and after Treatment. Results: After the use of medicines there was a significant reduction in the degree of annoyance caused by Tinnitus, there was a significant reduction of tinnitus and there was significant improvement in hearing thresholds, consequently, on the Quality of Life of the respondents. Conclusion: This Study allowed the Verification that the use of Caroverine, Ginkgo Biloba and Multivitamin for the Treatment of Tinnitus and their Effect.

The international tinnitus journal, 2012

The perception of tinnitus varies among individuals. The limitations caused by tinnitus are related to psychological factors, mood changes and psychiatric conditions, while other factors related to discomfort caused by tinnitus are being studied. Hearing loss is an important factor for the onset of tinnitus. To evaluate the correlation between the degree of discomfort caused by tinnitus and the hearing loss level. A retrospective study of the patients treated at the Otolaryngology Service of the State University from Campinas for 15 months, using the Visual-Analogue Scale to classify the degree of discomfort by tinnitus. 107 patients were studied and there was no correlation between the degree of annoyance of tinnitus with hearing loss, age, gender, presence of dizziness, of neck pain, headache, changes of the temporomandibular joint, the use of caffeine or excessive intake of carbohydrates. The discomfort was slightly higher in patients without hearing loss and in women. Dizziness,...

Neuropsychiatric disease and treatment, 2014

The connection between psychopathology and tinnitus is complex and not adequately studied. The aim of this study is to investigate the relationship between tinnitus and psychiatric comorbidities from different points of view: categorical, dimensional, temperamental, and perceived stress level. Two hundred and thirty-nine patients affected by tinnitus were recruited between January and October 2012. Patients underwent a preliminary battery of tests including the Tinnitus Handicap Inventory (THI), Symptom Check List (SCL90-R), Temperament and Character Inventory (TCI), and Stress-Related Vulnerability Scale (VRS), and eventually a full psychiatric evaluation. One hundred and fourteen patients (48% of the total sample) presented psychiatric comorbidity. Among these, a higher prevalence of depression, somatization, obsession, and anxiety was found. More than 41% of patients affected by decompensated tinnitus reported a family history of psychiatric disorders. Significant positive correl...

Journal of Psychosomatic Research, 1992

Dimensions of psychological complaints due to chronic and disabling tinnitus were investigated by means of the Tinnitus Questionnaire (TQ), administered to a sample of 138 tinnitus sufferers who had been admitted to a psychosomatic hospital. Factor analysis revealed that tinnitus-related patterns of emotional and cognitive distress, intrusiveness, auditory perceptual difficulties, sleep disturbances, and somatic complaints can be differentiated. Cognitive distortions and inappropriate attitudes towards the tinnitus and it's personal consequences were found to be highly intercorrelated forming a subgroup within a broader and more general distress factor. The stability of the factor solution obtained was examined by systematically varying the number of factors to be extracted. Based on the results of this method, scales are proposed for the questionnaire which can be used in clinical and scientific work to specifically assess major areas of tinnitus-related distress and their degree of severity. Implications for a further evaluation of the instrument are discussed.

European Archives of Oto-Rhino-Laryngology, 2012

The study was carried out to determine the impact of some co-morbid otological symptoms and demographic factors on the emotional distress and cognitive functioning in patients with tinnitus. One hundred consecutive patients, complaining of constant idiopathic tinnitus, were enrolled into the study. Four tests were administered: Beck Depression Inventory, Hospital Anxiety Depression Scale (HADS, A-anxiety, D-depression), Mini-Mental State Examination (MMSE) and Trail Making Test (TMT). A multivariate stepwise linear regression analysis was performed to estimate the relationship between the results of each of the tests and following co-morbid factors: age, sex, tinnitus duration, tinnitus laterality, hearing status (normal hearing, unilateral hearing loss and bilateral hearing loss) and vertigo/dizziness. It was found that the scores of MMSE and TMT were negatively correlated with age and with hearing status and the scores of HADS-A were slightly correlated with sex. In regression analysis, in HADS-A, sex and to a lesser extent tinnitus duration, in MMSE and TMT age and to a lesser extent tinnitus laterality were the variables that were comprised in the final model. Demographic factors had contributed more than overlapping otological symptoms to the psychological outcome in tinnitus patients.