Sahlsten Hanna, Taiminen Tero, Karukivi Max, Sjösten Noora, Nikkilä Johanna, Virtanen Juuso, Paavola Janika, Joutsa Juho, Niinivirta-Joutsa Katri, Takala Mari, Holm Anu, Rauhala Esa, Löyttyniemi Eliisa, Johansson Reijo, Jääskeläinen Satu K
a Faculty of Medicine , University of Turku , Turku , Finland.
b Department of Psychiatry , Turku University Hospital , Turku , Finland.
Int J Audiol. 2018 Apr;57(4):302-312. doi: 10.1080/14992027.2017.1409440. Epub 2017 Nov 30.
Chronic tinnitus has been associated with several psychiatric disorders. Only few studies have investigated these disorders using validated diagnostic interviews. The aims were to diagnose psychiatric and personality disorders with structured interviews, to assess self-rated psychiatric symptoms and elucidate temporal relations between psychiatric disorders and tinnitus.
Current and lifetime DSM-IV diagnoses of axis-I (psychiatric disorders) and axis-II (personality disorders) were assessed using structured clinical interviews (SCID-I and -II). Current subjective psychiatric symptoms were evaluated via self-rating instruments: the Symptom Check List-90 (SCL-90), the Beck Depression Inventory, and the Dissociative Experiences Scale (DES).
83 patients (mean age 51.7, 59% men) with chronic, disturbing tinnitus and a median Tinnitus Handicap Inventory score of 32.
The rates of lifetime and current major depression were 26.5% and 2.4%. The lifetime rate of obsessive-compulsive personality disorder (type C) was 8.4%. None of the patients had cluster B personality disorder or psychotic symptoms. The SCL-90 subscales did not differ from the general population, and median DES score was low, 2.4.
Tinnitus patients are prone to episodes of major depression and often also have obsessive-compulsive personality features. Psychiatric disorders seem to be comorbid or predisposing conditions rather than consequences of tinnitus. Clinical trial reference: ClinicalTrials.gov (ID NCT 01929837).
慢性耳鸣与多种精神障碍有关。仅有少数研究使用经过验证的诊断访谈来调查这些障碍。本研究旨在通过结构化访谈诊断精神障碍和人格障碍，评估自评精神症状，并阐明精神障碍与耳鸣之间的时间关系。
使用结构化临床访谈（SCID-I和-II）评估轴I（精神障碍）和轴II（人格障碍）的当前及终生DSM-IV诊断。通过自评工具评估当前主观精神症状：症状自评量表90（SCL-90）、贝克抑郁量表和分离体验量表（DES）。
83例慢性、烦扰性耳鸣患者（平均年龄51.7岁，59%为男性），耳鸣致残量表评分中位数为32。
终生及当前重度抑郁症的发生率分别为26.5%和2.4%。强迫型人格障碍（C型）的终生发生率为8.4%。所有患者均无B类人格障碍或精神病性症状。SCL-90各分量表与一般人群无差异，DES评分中位数较低，为2.4。
耳鸣患者易患重度抑郁发作，且常具有强迫型人格特征。精神障碍似乎是共病或诱发因素，而非耳鸣的后果。临床试验注册号：ClinicalTrials.gov（ID NCT 01929837）。
