Psychosocial consequences of the loudness of tinnitus

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.

Acta …, 2012

Tinnitus represents one of the most frequent symptoms observed in the general population in association with different pathologies, although often its etiology remains unclear. Objective of this work is to evidence the main aspects concerning epidemiology, causes, audiological characteristics and psychological consequences of tinnitus.

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.

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 Tinnitus Journal, 2013

The present study investigated the relationship between the perceived tinnitus severity, depressive and anxiety symptoms in individuals with tinnitus. An attempt was also made to see if any relationship exists between the perceived tinnitus severity and the age, gender or hearing status of the sufferer. Materials and Methods: Fifty individuals (31 males, 19 females) with tinnitus (age range 19 to 60 years) were enrolled in the study. After the routine pure tone audiometry, each participant completed the Tinnitus Handicap Inventory, the State-Trait Anxiety Inventory and the Inventory of Depressive Symptomatology-Self Report-30. Results: A significant correlation (r = 0.585, p < 0.01) was found between the perceived tinnitus severity, as indicated by the Tinnitus Handicap Inventory scores and depressive symptoms. Tinnitus Handicap Inventory scores also correlated significantly with both state and trait anxiety levels (r = 0.602, p<0.01; r = 0.426, p < 0.01 respectively). Furthermore, age, gender and hearing status did not significantly influence the perceived severity of tinnitus. Conclusion: The results support the view that there is a strong relation between tinnitus and anxiety-depressive symptoms. Further, perceived severity of tinnitus is not influenced by age, gender and hearing status of the individual.

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 Human Neuroscience, 2016

Objective: The primary cause of subjective tinnitus is a dysfunction of the auditory system; however, the degree of distress tinnitus causes depends largely on the psychological status of the patient. Our goal was to attempt to associate the grade of tinnitus-related distress with the psychological distress, physical, or psychological discomfort patients experienced, as well as potentially relevant social parameters, through a simultaneous analysis of these factors. Methods: We determined the level of tinnitus-related distress in 531 tinnitus patients using the German version of the tinnitus questionnaire (TQ). In addition, we used the Perceived Stress Questionnaire (PSQ); General Depression Scale Allgemeine Depression Skala (ADS), Berlin Mood Questionnaire (BSF); somatic symptoms inventory (BI), and SF-8 health survey as well as general information collected through a medical history. Results: The TQ score significantly correlated with a score obtained using PSQ, ADS, BSF, BI, and SF-8 alongside psychosocial factors such as age, gender, and marital status. The level of hearing loss and the auditory properties of the specific tinnitus combined with perceived stress and the degree of depressive mood and somatic discomfort of a patient were identified as medium-strong predictors of chronic tinnitus. Social factors such as gender, age, or marital status also had an impact on the degree of tinnitus distress. The results that were obtained were implemented in a specific cortical distress network model. Conclusions: Using a large representative sample of patients with chronic tinnitus permitted a simultaneous statistical measurement of psychometric and audiological parameters in predicting tinnitus distress. We demonstrate that single factors can be distinguished in a manner that explains their causative association and influence on the induction of tinnitus-related distress.

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,...