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Bidirectional Associations Between Tinnitus Subtypes and Psychiatric Conditions.

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Non-pulsatile tinnitus (NPT) significantly increases the risk of developing generalized anxiety disorder (GAD) and major depression (MD). Pulsatile tinnitus (PT) patients showed a bidirectional link with these psychiatric conditions, suggesting integrated mental health care is crucial.

Keywords:
generalized anxiety disordermajor depressionnon‐pulsatile tinnituspsychiatric comorbiditiespulsatile tinnitus

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Area of Science:

  • Otolaryngology
  • Psychiatry
  • Epidemiology

Background:

  • Tinnitus is a common auditory perception with distinct subtypes, including pulsatile tinnitus (PT) and non-pulsatile tinnitus (NPT).
  • Psychiatric conditions like generalized anxiety disorder (GAD) and major depression (MD) are frequently comorbid with tinnitus, but subtype-specific relationships remain unclear.

Purpose of the Study:

  • To investigate the temporal and bidirectional associations between tinnitus subtypes (PT and NPT) and the development of GAD and MD.
  • To compare the psychiatric burden associated with PT versus NPT.

Main Methods:

  • Retrospective cohort study using TriNetX Research Network data (>140 million patients).
  • Patients classified by ICD-10 codes for PT, NPT, GAD, and MD.
  • Propensity score matching (PSM) applied to control confounders; statistical analyses included odds ratios (OR) with 95% confidence intervals (CIs).

Main Results:

  • Non-pulsatile tinnitus (NPT) patients exhibited significantly higher risks of developing GAD and MD compared to pulsatile tinnitus (PT) patients.
  • PT patients demonstrated consistently lower risks for developing GAD and MD, even in treated/untreated subgroups.
  • Among tinnitus patients, those with pre-existing GAD or MD were more likely to have PT than NPT.

Conclusions:

  • NPT is linked to a greater risk of developing GAD and MD, indicating a higher psychiatric burden.
  • A bidirectional relationship exists between PT and pre-existing GAD/MD.
  • Findings emphasize integrating mental health assessments into tinnitus care and developing subtype-specific management strategies.