Factors Associated With Depression in Patients With Tinnitus and Hyperacusis

The purpose of this study was to assess factors associated with depression for patients with tinnitus and hyperacusis.

Data were gathered from the records of 620 consecutive patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic in the United Kingdom.

One third of the patients had borderline abnormal or abnormal scores on the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Linear regression models showed that HADS-D scores were related to scores for tinnitus handicap, tinnitus loudness, and uncomfortable loudness levels. Mediation analyses showed that (a) the influence of tinnitus handicap scores on HADS-D scores was mainly mediated via the effects of insomnia, hyperacusis, and anxiety; (b) the influence of tinnitus loudness scores on HADS-D scores was fully mediated via the effects of tinnitus handicap, insomnia, hyperacusis handicap, and anxiety; (c) and the small influence of uncomfortable loudness levels on HADS-D scores was fully mediated by hyperacusis handicap and anxiety.

Those involved in the management of patients with tinnitus and/or hyperacusis should use a wide range of instruments to assess the full impact of tinnitus on a patient's life and should be prepared to refer a patient for treatment for depression, especially when the patient has anxiety, hyperacusis, and/or insomnia.