Tinnitus severity and dizziness: The role of psychological distress in a population-based study

To investigate the association between tinnitus severity and dizziness in a nationally representative sample of adults aged ≥40 years and to evaluate the contribution of psychological distress (anxiety and perceived stress).

We analyzed data from 7634 participants in the Korea National Health and Nutrition Examination Survey (2022-2023). Dizziness was defined as self-reported symptoms within the past 12 months. Tinnitus severity was categorized as mild, moderate, or severe compared with no tinnitus. Survey-weighted logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) with sequential adjustment for sociodemographic factors, health behaviors, comorbidities, and psychological variables.

Among adults aged 40 years and older, the weighted proportions of participants reporting dizziness and tinnitus symptoms were 33.7% and 10.2%, respectively. Tinnitus severity showed a graded association with dizziness (p for trend = 0.003 in Model 4). Compared with the no‑tinnitus group, moderate and severe tinnitus were associated with higher odds of dizziness after full adjustment (OR 1.71, 95% CI 1.33-2.20; OR 2.43, 95% CI 1.75-3.39). Anxiety severity and perceived stress were independently associated with dizziness, and adjustment for these factors attenuated the tinnitus-dizziness association by approximately 9% and 19% for moderate and severe tinnitus.

Tinnitus severity was independently associated with dizziness in a graded manner. Psychological distress was also associated with dizziness and partially attenuated this relationship, supporting a clinical approach that integrates auditory and psychological factors in the assessment of dizziness.