Bartels H, Middel B L, van der Laan B F A M, Staal M J, Albers F W J
Department of Otorhinolaryngology, University Medical Center Groningen, University of Groningen, The Netherlands.
Ear Hear. 2008 Dec;29(6):947-56. doi: 10.1097/AUD.0b013e3181888f83.
Evaluating the effect of anxiety and depression on clinical measures of general health, tinnitus-specific quality of life, and coping abilities.
Two hundred sixty-five chronic, subjective tinnitus sufferers were divided into four psychological symptom groups according to cut-off scores on anxiety and depression subscales of the Hospital Anxiety and Depression Scale: (1) no-symptoms, (2) anxiety-only, (3) depression-only, and (4) anxiety-plus-depression. General health-related quality of life (SF-36), tinnitus-specific quality of life (tinnitus reaction questionnaire and tinnitus handicap inventory), and coping abilities (tinnitus coping style questionnaire) were assessed and analyzed across these four psychological symptom groups, which did not differ on age, gender, marital, and working status.
Statistically significant and clinically relevant differences on general health-related and tinnitus-specific quality of life and coping abilities were identified when comparing anxiety-plus-depression subgroup with the subgroups anxiety-only, depression-only, or no-symptoms. Highest associations were seen between the anxiety-plus-depression subgroup and impaired quality of life and maladaptive coping.
Our results demonstrate the additive effect of both anxiety and depression in impairing general health-related and tinnitus-specific quality of life and application of coping strategies, and reiterate the need for investigating both symptoms in the clinical evaluation of tinnitus patients.
评估焦虑和抑郁对总体健康的临床指标、耳鸣特异性生活质量及应对能力的影响。
根据医院焦虑抑郁量表中焦虑和抑郁分量表的临界值,将265名慢性主观性耳鸣患者分为四个心理症状组:(1)无症状组,(2)仅焦虑组,(3)仅抑郁组,(4)焦虑加抑郁组。对这四个心理症状组的总体健康相关生活质量(SF-36)、耳鸣特异性生活质量(耳鸣反应问卷和耳鸣障碍量表)及应对能力(耳鸣应对方式问卷)进行评估和分析,这四组在年龄、性别、婚姻状况和工作状态方面无差异。
将焦虑加抑郁亚组与仅焦虑亚组、仅抑郁亚组或无症状亚组进行比较时,在总体健康相关及耳鸣特异性生活质量和应对能力方面发现了具有统计学意义且与临床相关的差异。焦虑加抑郁亚组与生活质量受损及适应不良应对之间的关联最为明显。
我们的结果表明焦虑和抑郁在损害总体健康相关及耳鸣特异性生活质量和应对策略应用方面具有累加效应,并重申在耳鸣患者的临床评估中需要同时调查这两种症状。