Tinnitus perception mediates the relationship between physiological and psychological problems in patients with tinnitus
Muhammad Aqeel and Tanvir Akhtar
Foundation University, Rawalpindi, Pakistan
: J Otol Rhinol
In its most persistent form, tinnitus is a subjective and painful phantom auditory phenomenon. Although there is ample research on its comorbidity with stress, depression and anxiety, that on comorbidity with other fundamental psychiatric disorders, for instance mood disorders, has obtained less concentration. The present study aimed to examine the relationship of tinnitus with stress, anxiety, depression, and mood disorders, and to identify potential mediation pathways among them in male and female patients with tinnitus. A cross-sectional design and purposive sampling were applied. Four instruments were employed to assess hearing impairment, stress, anxiety, depression, positive and negative mood swings in patients with tinnitus. 100 adult patients (males=60; females=40) diagnosed with chronic tinnitus have approached to different private and public hospitals, at their respective ENT and audiology departments in Rawalpindi and Lahore, Pakistan, in 2016. They underwent complete physiological and psychological tinnitus evaluations such as tinnitus matching, audiometry, and assessments using standardized tinnitus instruments. Specifically, the following three psychological instruments were used to assess tinnitus perception, negative and positive affect; and stress, anxiety, and depression, respectively: the depression anxiety stress scale; the tinnitus handicap inventory; positive and negative affect schedule. The correlation and mediation analyses were employed to examine the data. Findings revealed that hearing impairment and tinnitus perception significantly positively predicted psychological problems. Additionally, tinnitus perception significantly and fully mediated the relationship of hearing impairment with anxiety, stress, and depression for male patients with tinnitus. Among females, tinnitus perception mediated the relationship of hearing impairment with positive and negative affect. These findings imply that physiological problems such as tinnitus and hearing impairment could stimulate psychological symptoms like stress, anxiety, depression, and negative and positive mood swings in male and female adults with tinnitus. Our study included patients only from two major cities of Pakistan; consequently, its results may not be generalizable to the entire population. In future, experimental and cross-sectional studies with more diverse sample will help explain the mechanism through which tinnitus affects psychological problems across genders. Additionally, the use of indigenous instruments to assess gender-related psychological problems, which consider cultural aspects as well, would be beneficial
M. Aqeel has published over 8 books, 2 chapter and 40 research articles. Currently, he is a faculty member at Foundation University Islamabad. His research interests include Public Health, Psychology, Social and Cultural effects and other health and environmental related issues.