Aazh Hashir, Moore Brian C J
Tinnitus & Hyperacusis Therapy Specialist Clinic, Audiology Department, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, United Kingdom.
Department of Experimental Psychology, University of Cambridge, United Kingdom.
Am J Audiol. 2017 Dec 12;26(4):562-569. doi: 10.1044/2017_AJA-17-0008.
The purpose of this study was to assess factors associated with depression for patients with tinnitus and hyperacusis.
Data were gathered from the records of 620 consecutive patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic in the United Kingdom.
One third of the patients had borderline abnormal or abnormal scores on the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Linear regression models showed that HADS-D scores were related to scores for tinnitus handicap, tinnitus loudness, and uncomfortable loudness levels. Mediation analyses showed that (a) the influence of tinnitus handicap scores on HADS-D scores was mainly mediated via the effects of insomnia, hyperacusis, and anxiety; (b) the influence of tinnitus loudness scores on HADS-D scores was fully mediated via the effects of tinnitus handicap, insomnia, hyperacusis handicap, and anxiety; (c) and the small influence of uncomfortable loudness levels on HADS-D scores was fully mediated by hyperacusis handicap and anxiety.
Those involved in the management of patients with tinnitus and/or hyperacusis should use a wide range of instruments to assess the full impact of tinnitus on a patient's life and should be prepared to refer a patient for treatment for depression, especially when the patient has anxiety, hyperacusis, and/or insomnia.
本研究旨在评估耳鸣和听觉过敏患者中与抑郁相关的因素。
数据收集自620例连续患者的记录，这些患者在英国一家听力诊所寻求耳鸣或听觉过敏方面的帮助。
三分之一的患者在医院焦虑抑郁量表（HADS-D）的抑郁分量表上得分处于临界异常或异常水平。线性回归模型显示，HADS-D得分与耳鸣致残率、耳鸣响度和不适响度水平得分相关。中介分析表明：（a）耳鸣致残率得分对HADS-D得分的影响主要通过失眠、听觉过敏和焦虑的作用来介导；（b）耳鸣响度得分对HADS-D得分的影响完全通过耳鸣致残率、失眠、听觉过敏致残率和焦虑的作用来介导；（c）不适响度水平对HADS-D得分的微小影响完全由听觉过敏致残率和焦虑介导。
参与耳鸣和/或听觉过敏患者管理的人员应使用多种工具来评估耳鸣对患者生活的全面影响，并应准备好将患者转介接受抑郁治疗，尤其是当患者有焦虑、听觉过敏和/或失眠时。
