Health-Related Quality of Life, Depressive Symptoms, Anxiety, and Somatization Symptoms in Male and Female Patients with Chronic Tinnitus

Abstract

Objective: To investigate the joint impact of tinnitus-related distress (TRD), anxiety, depressive symptoms, and other somatization symptoms on health-related quality of life (HRQoL) in female vs. male patients with chronic tinnitus. Method: Three-hundred-and-fifty-two patients with chronic tinnitus completed audiological testing and a psychological assessment battery that comprised—among other measures—German versions of the Tinnitus Questionnaire, Hospital Anxiety and Depression Scale, Somatic Symptom Scale-8, and Health-Related Quality of Life scale. Descriptive analyses examined associations as well as within- and between-gender differences of the measured variables. Gender-specific serial indirect effects analyses aimed to explain the impact of TRD on HRQoL through psychological processes, notably anxiety, depressive symptoms, and somatization symptoms. Results: Both female and male patients yielded lower mental than physical HRQoL and negative associations between the measured psychological variables and HRQoL. Compared to male patients, female patients reported higher levels of tinnitus-related- and wider psychological distress, other somatization symptoms (e.g., headaches), and impairments in mental and physical HRQoL. For each gender, depressive symptoms, anxiety, and somatization symptoms fully mediated the effect of TRD on mental and physical HRQoL. A double-dissociation revealed an interaction of somatization symptoms and depression on the TRD-HRQoL association in women, and of somatization symptoms and anxiety in men. Conclusions: In patients with chronic tinnitus, psychological constructs account for reported impairments in both mental and physical HRQoL. To improve patients’ HRQoL, treatment conceptualizations should consider gender-specific psychological expressions of low mood or anxiety.

Age-Related Hearing Loss With Tinnitus and Physical Frailty Influence the Overall and Domain-Specific Quality of Life of Chinese Community-Dwelling Older Adults

“…These results extend our understanding of the association among the severity of ARHL (8,9), tinnitus (10,18), physical frailty (13,14,26), and the presence of ARHL and/or tinnitus (17) with HRQoL. Furthermore, these findings provide more evidence on the interaction among ARHL, tinnitus, and physical frailty in their relationship with HRQoL after adjusting for demographic, health-related, and psychosocial factors.…”

“…Physical frailty coexisting with ARHL, tinnitus, and ARHL with tinnitus had a stronger effect on the overall HRQoL. Several previous studies have indicated that ARHL ( 8 , 9 , 28 , 29 ) and/or tinnitus ( 10 , 30 ) were negatively associated with HRQoL. However, we found no significant association among ARHL severity, the presence of ARHL and/or tinnitus, and HRQoL, and the association between tinnitus severity and HRQoL was also no longer significant after adjustment for psychosocial factors.…”

“…The effects of age-related auditory disorders (ARHL and tinnitus) on the specific domains of HRQoL were significantly different from those of physical frailty. Previous studies have indicated that ARHL, tinnitus, and the presence of ARHL and/or tinnitus were significantly associated with physical function ( 7 ), frailty phenotypes ( 3 ), cognition ( 31 , 32 ), social dysfunction ( 33 ), and psychological disorders (e.g., depressive symptoms and anxiety) ( 10 , 11 , 24 , 34 ). However, this study found no significant associations between these age-related auditory disorders and the psychosocial dimensions of HRQoL.…”

“…The severity of ARHL ( 9 ) and tinnitus ( 10 ), and the presence of ARHL and tinnitus ( 11 ) have been reported to be associated with poor health-related quality of life (HRQoL). Physical frailty is an emerging global health burden, affecting ~11% of older community-dwelling adults in high-income countries and having an even higher prevalence in low-income countries ( 2 , 12 ).…”

“…Moreover, patients with hearing loss with tinnitus have lower mobility, usual activity, and anxiety/depression HRQoL than those with a normal hearing without tinnitus ( 17 ). In studies that assessed the overall HRQoL of patients with hearing loss and tinnitus using the Medical Outcomes Study 36-item Short-Form Health Survey (12-item) ( 10 , 18 ), individuals with more severe tinnitus had worse physical, bodily pain, vitality, and mental health scores ( 18 ). Further, sex, depressive symptoms, anxiety, and somatization symptoms were found to regulate the effect of chronic tinnitus on the mental and physical dimensions of HRQoL ( 10 ).…”