The influence of psychological factors on tinnitus severity

Milerová, Jana; Anders, Martin; Dvořák, Tomáš; Sand, Philipp G.; Königer, Stefanie; Langguth, Berthold

doi:10.1016/j.genhosppsych.2013.02.008

Cited by 66 publications

(58 citation statements)

References 41 publications

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“…One option is the presentation of scores for each measurement instrument. The rationale of this approach is that even if most of these measurements correlate with each other, they assess slightly different aspects of an individual’s tinnitus (17, 18). A further option is the use of statistical methods (namely Principal Components Analysis) to tease apart independent components of the condition in a data-driven way (19).…”

Section: Introductionmentioning

confidence: 99%

Visualization of Global Disease Burden for the Optimization of Patient Management and Treatment

et al. 2017

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BackgroundThe assessment and treatment of complex disorders is challenged by the multiple domains and instruments used to evaluate clinical outcome. With the large number of assessment tools typically used in complex disorders comes the challenge of obtaining an integrative view of disease status to further evaluate treatment outcome both at the individual level and at the group level. Radar plots appear as an attractive visual tool to display multivariate data on a two-dimensional graphical illustration. Here, we describe the use of radar plots for the visualization of disease characteristics applied in the context of tinnitus, a complex and heterogeneous condition, the treatment of which has shown mixed success.MethodsData from two different cohorts, the Swedish Tinnitus Outreach Project (STOP) and the Tinnitus Research Initiative (TRI) database, were used. STOP is a population-based cohort where cross-sectional data from 1,223 non-tinnitus and 933 tinnitus subjects were analyzed. By contrast, the TRI contained data from 571 patients who underwent various treatments and whose Clinical Global Impression (CGI) score was accessible to infer treatment outcome. In the latter, 34,560 permutations were tested to evaluate whether a particular ordering of the instruments could reflect better the treatment outcome measured with the CGI.ResultsRadar plots confirmed that tinnitus subtypes such as occasional and chronic tinnitus from the STOP cohort could be strikingly different, and helped appreciate a gender bias in tinnitus severity. Radar plots with greater surface areas were consistent with greater burden, and enabled a rapid appreciation of the global distress associated with tinnitus in patients categorized according to tinnitus severity. Permutations in the arrangement of instruments allowed to identify a configuration with minimal variance and maximized surface difference between CGI groups from the TRI database, thus affording a means of optimally evaluating the outcomes in individual patients.ConclusionWe anticipate such a tool to become a starting point for more sophisticated measures in clinical outcomes, applicable not only in the context of tinnitus but also in other complex diseases where the integration of multiple variables is needed for a comprehensive evaluation of treatment response.

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Section: Introductionmentioning

confidence: 99%

Visualization of Global Disease Burden for the Optimization of Patient Management and Treatment

et al. 2017

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“…15 In particular, as there is presently no effective medical or psychological therapy available to cure tinnitus, it is of the utmost importance to better understand the sensory and cognitive mechanisms that directly or indirectly may result in alterations of cortical architecture. Careful research of the circumstances and conditions under which these changes occur may help to answer a number of 20 pertinent questions. One important issue relates to the heterogeneity of the TI population which may be subdivided into a number of various tinnitus subtypes [6,13].…”

Section: Introductionmentioning

confidence: 99%

“…A relevant question in this context pertains to the role that one cardinal feature, namely emotional distress, 1 plays in tinnitus subtyping [16,17,18,19]. Recent research has shown that there is a high variability among people with 25 tinnitus in the degree to which they are emotionally affected by the chronic noise [20]. While some TI learn to ignore and to cope with the disturbing noise, others begin to develop symptoms of mental, psychological and emotional disorders.…”

Section: Introductionmentioning

confidence: 99%

Differential tinnitus-related neuroplastic alterations of cortical thickness and surface area

et al. 2016

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Structural neuroimaging techniques have been used to identify cortical and subcortical regions constituting the neuroarchitecture of tinnitus. One recent investigation used voxel-based morphometry (VBM) to analyze a sample of tinnitus patients (TI, n=257) [1]. A negative relationship between individual distress and cortical volume (CV) in bilateral auditory regions was observed. However, CV has meanwhile been identified as a neuroanatomical measurement that confounds genetically distinct neuroanatomical traits, namely cortical thickness (CT) and cortical surface area (CSA). We performed a re-analysis of the identical sample using the automated FreeSurfer surface-based morphometry (SBM) approach [2]. First, we replicated the negative correlation between tinnitus distress and bilateral supratemporal gray matter volume. Second, we observed a negative correlation for CSA in the left peri-auditory cortex and anterior insula. Furthermore, we noted a positive correlation between tinnitus duration and CT in the left peri-auditory cortex as well as a negative correlation in the subcallosal anterior cingulate, a region collated to the serotonergic circuit and germane to inhibitory functions. In short, the results elucidate differential neuroanatomical alterations of CSA and CT for the two independent tinnitus-related psychological traits distress and duration. Beyond this, the study provides further evidence for the distinction and specific susceptibility of CSA and CT within the context of neuroplasticity of the human brain. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A negative relationship between individual distress and cortical volume (CV) in bilateral auditory regions was observed. However, CV has meanwhile been identified as a neuroanatomical measurement that confounds genetically distinct neuroanatomical traits, namely cortical thickness (CT) and cortical surface area (CSA). We performed a re-analysis of the identical sample using the automated FreeSurfer surface-based morphometry (SBM) approach [2]. First, we replicated the negative correlation between tinnitus distress and bilateral supratemporal gray matter volume. Second, we observed a negative correlation for CSA in the left peri-auditory cortex and anterior insula. Furthermore, we noted a positive correlation between tinnitus duration and CT in the left peri-auditory cortex as well as a negative correlation in the subcallosal anterior cingulate, a region collated to the serotonergic circuit and germane to inhibitory functions. In short, the results elucidate differential neuroanatomical alterations of CSA and CT for the two independent...

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“…In addition to its known acoustic symptoms, tinnitus is also associated with emotional and cognitive dysfunction 12. In many cases, tinnitus is associated with psychological and psychosomatic problems caused by emotional and cognitive dysfunction in addition to the acoustic properties of the condition.…”

Section: Introductionmentioning

confidence: 99%

Coexistence of anxiety sensitivity and psychiatric comorbidities in patients with chronic tinnitus

Gül¹,

Özkırış²,

Aydin³

et al. 2015

NDT

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BackgroundTinnitus refers to the objective or subjective perception of a series of sounds most frequently described as ringing in the ear or within the head itself. Anxiety and depressive disorders frequently accompany this complaint. In this study, we aimed to investigate the presence of psychiatric symptoms and the degree of anxiety sensitivity in patients with chronic tinnitus.MethodsFifty patients with chronic tinnitus who had been followed up for at least 6 months or longer were enrolled in this study. All subjects completed the Anxiety Sensitivity Index-3 (ASI-3), Stait-Trait Anxiety Inventory (STAI), and Symptom Check List-90-Revised (SCL-90-R) questionnaires. Fifty healthy volunteers were given the same tests and a statistical comparison of the psychometric outcome data was done for subjects with and without chronic tinnitus.ResultsPatients with chronic tinnitus demonstrated higher statistically meaningful scores than the healthy group. Comparison between chronic tinnitus group and control group scores showed that patient group has a high rate of statistically significant results than controls; ASI-3, STAI-2, SCL-90-R GSI, SCL-90-R Somatization, SCL-90-R Depression, SCL-90-R Anxiety (z=−8.00, P<0.01), SCL-90-R Phobic Anxiety.ConclusionHigher scores for anxiety sensitivity and other psychiatric symptoms in patients with chronic tinnitus reflects the prevalence of psychiatric disorders such as depression, anxiety, somatoform disorder, and chronic tinnitus. The finding of more psychiatric comorbidity in patients with chronic tinnitus indicates that planning and follow-up in both otolaryngology and psychiatry is necessary to improve the overall results of treatment.

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The influence of psychological factors on tinnitus severity

Cited by 66 publications

References 41 publications

Visualization of Global Disease Burden for the Optimization of Patient Management and Treatment

Visualization of Global Disease Burden for the Optimization of Patient Management and Treatment

Differential tinnitus-related neuroplastic alterations of cortical thickness and surface area

Coexistence of anxiety sensitivity and psychiatric comorbidities in patients with chronic tinnitus

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