Bidirectional Associations Between Tinnitus Subtypes and Psychiatric Conditions

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.