Evaluation of chronic idiopathic tinnitus and its psychosocial triggers  

作　　者：Sherifa Ahmed Hamed Fadia Ahmed Attiah Mohamed Fawzy Mohamed Azzam 

机构地区：[1]Department of Neurology and Psychiatry,Assiut University,Faculty of Medicine,Assiut 71516,Egypt [2]Department of Otolaryngology,Assiut University,Faculty of Medicine,Assiut 71516,Egypt

出　　处：《World Journal of Clinical Cases》2023年第14期3211-3223,共13页世界临床病例杂志

摘　　要：BACKGROUND The tinnitus susceptibility patterns in relation to different psychological and life stressors are unknown in different cultures.AIM To determine the comorbid psychosocial factors and behaviors associated with tinnitus and the predictors for the increase in its severity.METHODS Participants were 230 adults(males=70;females=160;mean age=38.6±3.3).They underwent audiograms,speech discrimination and masking testing,and neuropsychiatric evaluation.Measures used for assessment included tinnitus handicap inventory,depression anxiety stress scale 21(DASS-21),perceived stress scale(PSS),and insomnia severity index(ISI).RESULTS Patients had mean duration of tinnitus of 11.5±2.5 mo.They had intact hearing perception at 250-8000 Hz and 95(41.3%)had aggravation of tinnitus loudness by masking noise.Decompensated tinnitus was reported in 77%(n=177).The majority had clinically significant insomnia(81.3%),somatic symptoms(75%)other than tinnitus and perceived moderate(46.1%)and high(44.3%)stress to tinnitus.The severe/extremely severe symptoms of depression,anxiety and stress were reported in 17.4%,35.7%and 44.3%,respectively.Patients with decompensated type had significantly higher scores for ISI(P=0.001)and DASS-21(depression=0.02,anxiety=0.01,stress=0.001)compared to those with compensated tinnitus.Psychiatric interviewing showed that 35.7%had non-specific anxiety disorder,17.4%had major depression,and 19.6%fulfilled the criteria of somatization disorder.Multivariate analysis showed that the only independent predictors for tinnitus severity were the duration of tinnitus[odd ratios(OR)=0.832,95%CI:0.640-1.158;P=0.001]and PSS(OR=0.835,95%CI:0.540-1.125;P=0.001)scores.CONCLUSION To the best of our knowledge,this is the first study in our culture to evaluate the causal relationship between psychological factors and tinnitus onset,severity and persistence.Tinnitus could be the earliest and dominant somatic symptom induced by life stressors and psychological vulnerabilities.Therefore,multidisciplinary consultation(psy

关 键 词：Chronic tinnitus IDIOPATHIC Stress Anxiety INSOMNIA SOMATIZATION Psychosocial factors 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]