Härter M, Maurischat C, Weske G, Laszig R, Berger M
Abteilung für Psychiatrie und Psychotherapie mit Poliklinik, Universitätsklinikum Freiburg, Freiburg,
HNO. 2004 Feb;52(2):125-31. doi: 10.1007/s00106-003-0889-8.
The majority of patients with chronic decompensated forms of tinnitus have comorbid psychological disorders, possibly accompanied by restricted quality of life and participation in everyday activities. There is no standardized tool to measure these clinically relevant dimensions.
Both the Hospital Anxiety and Depression Scale (HADS) and the Short Form 36 (SF-36) were administered to a consecutive sample of patients ( n=110) who were recruited from the tinnitus outpatient service in the department of psychiatry and psychotherapy. Using the Tinnitus Questionnaire (TF), associations of the HADS and SF-36 scales with tinnitus grading were determined and the classification of patients (mild-medium-severe-very severe) was evaluated.
A severe tinnitus grading is correlated to a high extent of anxiety and depression and a low quality of life. With the exception of the SF-36 subscale on physical functioning, all scales discriminated between the extreme groups (mild vs severe/very severe), but less between the two medium groups.
Patients with severe decompensated tinnitus (grades III and IV) should be seen for diagnosis of psychiatric comorbidity and supportive psychotherapy/psychopharmacotherapy used when necessary.
大多数慢性失代偿性耳鸣患者合并有心理障碍,可能伴有生活质量受限和日常活动参与度降低。目前尚无标准化工具来测量这些临床相关维度。
对从精神科和心理治疗科耳鸣门诊连续招募的110例患者样本同时施测医院焦虑抑郁量表(HADS)和简明健康状况调查问卷(SF-36)。使用耳鸣问卷(TF),确定HADS和SF-36量表与耳鸣分级的相关性,并评估患者(轻度-中度-重度-极重度)的分类。
严重耳鸣分级与高度焦虑、抑郁以及低生活质量高度相关。除SF-36身体功能分量表外,所有量表在极端组(轻度与重度/极重度)之间有区分度,但在两个中等组之间区分度较小。
对于严重失代偿性耳鸣(III级和IV级)患者,应进行精神科共病诊断,并在必要时采用支持性心理治疗/心理药物治疗。