Department of Neurology and Psychiatry, Umberto I University Hospital, Sapienza University, Rome, Italy.
Psychosomatics. 2013 May-Jun;54(3):248-56. doi: 10.1016/j.psym.2012.05.007. Epub 2012 Dec 7.
Psychiatric comorbidity is common in patients who seek help for tinnitus. The perceived severity of tinnitus correlates closer to psychological and general health factors than to audiometrical parameters. Audiologists need valid screening tools in order to identify patients with psychiatric disorders and to tailor treatment in a multidisciplinary setting. The tinnitus handicap inventory (THI) has gained widespread acceptance as a self-report measure of tinnitus handicap. In several studies, THI test score correlates with the level of psychopathologic distress. The aim of our study was to investigate the predictive power of the test THI in relation to psychiatric disorders.
We recruited 156 patients with chronic tinnitus who have requested help at our tinnitus center. All patients underwent psychiatric evaluation, the diagnosis was made in agreement with the DSMIV-TR criteria; all patients filled out the following questionnaires: THI, Symptomatic Check List-90-Revised (SCL-90-R) and Stress-related Vulnerability Scale (VRS). Sensibility and specificity of tests as screening tool for psychiatric disorders was evaluated using Receiver Operating Characteristic (ROC) curve.
Sixty-eight patients (prevalence: 43.59%) were found to be affected by a psychiatric disorder. AUC = 0.792 (p > 0.001) shows that THI is a moderately accurate test to individuate psychiatric affected people among our sample. We identified a score of 36 at THI (sensibility = 86.76%; specificity = 59.09%) as an appropriate cut-off point.
If a patient reports a THI score greater than 36, the audiologist should supplement diagnostic studies with a psychiatric evaluation.
在寻求耳鸣治疗的患者中，精神共病较为常见。耳鸣的感知严重程度与心理和整体健康因素的相关性，要高于与听力学参数的相关性。听力学家需要有效的筛查工具，以便识别出患有精神障碍的患者，并在多学科环境中进行针对性治疗。耳鸣残疾量表（THI）已作为耳鸣残疾的自评量表而被广泛接受。在多项研究中，THI 测试分数与精神病理困扰的水平相关。我们的研究旨在调查 THI 测试分数与精神障碍之间的预测能力。
我们招募了 156 名患有慢性耳鸣并向我们的耳鸣中心寻求帮助的患者。所有患者均接受了精神病学评估，诊断符合 DSM-IV-TR 标准；所有患者均填写了以下问卷：THI、症状清单-90 修订版（SCL-90-R）和应激相关脆弱性量表（VRS）。使用受试者工作特征（ROC）曲线评估测试作为筛查工具的敏感性和特异性，以评估其用于诊断精神障碍的能力。
我们发现 68 名患者（患病率：43.59%）患有精神障碍。AUC = 0.792（p > 0.001）表明，THI 是一种中等准确性的测试，可以在我们的样本中识别出患有精神障碍的个体。我们确定 THI 评分为 36 分（敏感性= 86.76%；特异性= 59.09%）为合适的截断点。
如果患者的 THI 评分大于 36，则听力学家应通过精神病学评估来补充诊断研究。
