Impact of Multiple Factors on the Degree of Tinnitus Distress

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.

Journal of Experimental Psychopathology

The current study is the first substantial investigation to determine whether tinnitus perception mediates the relationship between physiological and psychological problems (PP). Simple random sampling, with a cross-sectional design, was used to collect data from 100 adult patients (males = 60; females = 40) diagnosed with chronic tinnitus. Subjects were approached through various public and private hospitals, at their respective Audiology and Ear, Nose, and Throat departments in Rawalpindi and Lahore, Pakistan. Participants underwent complete physiological and psychological tinnitus evaluations, such as tinnitus matching and audiometry, as well as assessments using standardized tinnitus instruments. The mediation analyses revealed an indirect relationship with hearing loss (HL) and PP (e.g., anxiety, stress, depression, mood swings) in tinnitus patients. These findings suggest that physiological problems such as tinnitus and HL might contribute to the development of psychological s...

Hearing Research, 2014

During the process of tinnitus diagnostics, various psychometric instruments are used to measure tinnitus-related distress. The aim of present work was to explore whether candidates for biological correlates of the tinnitus-related distress could be found in peripheral blood of patients and if so, whether there was association between them and psychometric scores that reflect tinnitus-related distress. The concentrations of interleukin-1b (IL1b), interleukin-6 (IL6), tumor necrosis factor-a (TNFa) and a brain-derived neutrotrophic factor (BDNF) were measured in serum of 30 patients diagnosed with chronic tinnitus and tested for correlation with psychometric scores collected on the same day. Spearman's correlation analyses detected significant positive association between the concentrations of tumor necrosis factor a and tinnitus loudness, total perceived stress, tension and depression and a negative association between tumor necrosis factor a and a psychometric score "joy". Concentrations of interleukin-1b correlated with the awareness grade of tinnitus. The correlation between visual analogue scale (VAS) "loudness" and tumor necrosis factor a as well as between "joy" and tumor necrosis factor a retained their significance (p < 0.00167) after the application of Bonferroni correction for multiple testing. Partial correlations removing the effects of age, hearing loss and the duration of tinnitus verified the results obtained using Spearman correlation. We conclude that measuring the concentrations of selected circulating cytokines could possibly become an additional objective element of tinnitus diagnostics in the future.

Ear and Hearing, 2011

Objectives: Tinnitus Disability Index (TDI) is presented as a novel and brief self-report measure for the assessment of the interference of tinnitus with performance in specific daily life activities. We hypothesized that the TDI is a reliable and valid measure and that tinnitus disability is strongly associated with tinnitus severity, subjective tinnitus intensity ratings, and ratings of general health.

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.

Frontiers in neurology, 2017

Acute tinnitus and its transition to chronic tinnitus are poorly investigated, and factors associated with amelioration exacerbation are largely unknown. Aims of this study were to identify early predictors for the future development of tinnitus severity. Patients with tinnitus of no longer than 4 weeks presenting at an otolaryngologist filled out questionnaires at inclusion (T1), as well as 3 (T3), and 6 months (T4) after tinnitus onset. 6 weeks after onset, an interview was conducted over the phone (T2). An audiogram was taken at T1, perceived tinnitus loudness, and tinnitus-related distress were assessed separately and repeatedly together with oversensitivity to external sounds and the levels of depression and anxiety. Furthermore, coping strategies with illness were recorded. Complete remission until T4 was observed in 11% of the 47 participants, while voiced complaints at onset were stable in the majority. In the subgroup with a relevant level of depression at T1, tinnitus-rela...

Journal of Psychosomatic Research, 2010

Clinical studies indicate a strong association between tinnitus and mental health, but results from general population data are missing. The purpose of the study was to examine the association between tinnitus, mental health, and wellbeing in the general adult population and to identify factors that might mediate and moderate this association. Methods: Data from 51,574 adults participating in the Nord-Trøndelag Hearing Loss Study (1995)(1996)(1997), part of the Nord-Trøndelag Health Study (HUNT-2), were analyzed. The association between tinnitus symptom intensity and symptoms of depression, anxiety, selfesteem, and subjective well-being was examined by multivariate ANOVA, stratified by age group and sex. Explanatory variables were age, marital status, education, hearing, dizziness, vision, physical disability, and somatic illness. In a subsample of participants with tinnitus, the effects of "time since onset," "predictability of tinnitus episodes," and "noise sensitivity" were tested. Results: Participants with tinnitus scored significantly higher on anxiety and depression and lower on self-esteem and well-being than people without tinnitus. The effect sizes were small and quite similar across levels of tinnitus symptom intensity. No significant effect of time since onset was found. A significant effect of predictability of tinnitus episodes and noise sensitivity was found in some groups. Conclusion: A weak association between tinnitus and mental health was found in this general population study.

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.

Deutsches Arzteblatt International, 2013

The article (1) unfortunately omits any mention of selfhelp. The charitable self-help organization Deutsche Tinnitus Liga (DTL, the German tinnitus association) makes a valuable contribution to support affected persons in this context (2). However, the authors deserve credit for explaining the topic of tinnitus so comprehensively. At the same time it should be clear that we are mostly talking about management, not cure. For patients with severe tinnitus, even just reducing the burden is a realistic therapeutic objective. Scientific evaluations have shown that of the 14 000 DTL members, 16% have grade 4 tinnitus (mini tinnitus questionnaire-12, Mini-TF12) (3). In order to confirm the effectiveness of self-help in qualified selfhelp groups, the DTL has started a large, prospective 3-year study in collaboration with the University Medical Center Hamburg-Eppendorf (2, 4). In our experience there are better grading scales for the severity of tinnitus than the external assessment that the authors list in the Box. The DTL on its home page provides a tinnitus test for interested parties that is based on the scientifically evaluated mini-tinnitus questionnaire 12 and is being undertaken by some 20 000 affected persons every year. 16% of these are most severely affected (3). The article mentions "tinnitus patients" in several places, sometimes for all those affected, but elsewhere for those who are actually suffering, which may well be termed "patients." If suffering caused by tinnitus is the main symptom then tinnitus should not be subsumed under the symptom category H 93.1 in the ICD-10 but should be integrated as a disease under a new category that is yet to be established.

International Journal of Audiology, 2009

This study tested a theoretical model of tinnitus-related distress and of general distress that involved acceptance of tinnitus symptoms and emotional intelligence as factors that may protect against such distress. One hundred and sixty-two tinnitus sufferers from throughout Australia completed measures of acceptance of tinnitus symptoms, emotional intelligence, tinnitus-related distress, and general distress. As hypothesized, greater acceptance of tinnitus symptoms was associated with less tinnitusrelated distress. Emotional intelligence was not associated with tinnitus distress. Greater acceptance and less tinnitus distress were both associated with less general distress, and the association between acceptance and general distress was mediated by tinnitus-related distress. The findings, which provide partial support for the tested model, may have implications for efforts to assist distressed tinnitus sufferers.