Zirke N, Goebel G, Mazurek B
Tinnituszentrum, HNO-Klink und Poliklinik, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin.
HNO. 2010 Jul;58(7):726-32. doi: 10.1007/s00106-009-2050-9.
Comorbidity is the presence of one or more disorders in addition to the main disorder. Comorbidities negatively influence the development of the main disease. For patients with tinnitus a comorbidity is an additional component complicating the habituation of ear noise and patients with decompensated tinnitus often have psychological comorbidities, e.g. affective, somatoform or anxiety disorders. At the time of first presentation and also during further follow-up, it is essential to pay particular attention to the presence of potential comorbid mental disorders. This is of special importance for patients with decompensated ear noise (severity grades 3 and 4). For ENT specialists it is important that the mental discomfort of patients must be taken seriously and should be identified through a targeted diagnosis. Effective treatment of the co-symptoms using cognitive behavior therapy (CBT) in conjunction with medication often reduces the severity of tinnitus perception and discomfort.
共病是指除主要疾病外还存在一种或多种疾病。共病会对主要疾病的发展产生负面影响。对于耳鸣患者来说,共病是使耳内噪声习惯化过程复杂化的一个额外因素,而耳鸣失代偿的患者通常有心理共病,如情感障碍、躯体形式障碍或焦虑症。在首次就诊时以及后续随访过程中,必须特别关注潜在的共病性精神障碍的存在。这对于耳鸣失代偿(严重程度为3级和4级)的患者尤为重要。对于耳鼻喉科专家而言,重要的是必须认真对待患者的心理不适,并应通过针对性诊断加以识别。使用认知行为疗法(CBT)结合药物对共症状进行有效治疗,通常会降低耳鸣感知的严重程度和不适感。