Department of Otorhinolaryngology, Jena University Hospital, Stoystr. 3, 07740 Jena, Germany.
Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
Psychiatry Res. 2019 Nov;281:112582. doi: 10.1016/j.psychres.2019.112582. Epub 2019 Sep 27.
Tinnitus describes the perception of a sound without external source and is characterized by high comorbidity, e.g. depression. In many studies, tinnitus patients were compared to healthy controls while a comorbid psychiatric diagnosis was an exclusion criterion. Consequently, patients with severe tinnitus and psychiatric comorbidity were often neglected. In the current study, we tried to fill this gap and compared four groups including two control groups: (1) chronic tinnitus patients with mild tinnitus distress (N = 37), (2) chronic tinnitus patients with severe tinnitus distress (N = 24), (3) patients suffering from depression, but no tinnitus (major depressive disorder, MDD; N = 23) and (4) healthy controls (N = 42). We assessed their clinical profile with clinical questionnaires concerning anxiety, depression and somatoform symptoms. Data were analyzed with a canonical discriminant analysis resulting in two factors. Factor 1 was called general psychopathology, because most questionnaires loaded highly on it. Regarding this factor, patients with severe tinnitus distress and MDD controls were impaired equally strong. Patients with mild tinnitus distress were more strongly affected than healthy controls. Both tinnitus groups reached higher values than the two control groups with regard to factor 2, called somatization. These results stress the presence of significant general psychopathology even in mild tinnitus.
耳鸣描述的是一种没有外部声源的声音感知,其特点是高共病性,例如抑郁症。在许多研究中,耳鸣患者与健康对照组进行了比较,而合并的精神科诊断则是排除标准。因此,严重耳鸣和精神共病的患者往往被忽视。在当前的研究中,我们试图填补这一空白,比较了包括两组对照组在内的四个组:(1) 慢性耳鸣患者,耳鸣困扰程度较轻(N=37),(2) 慢性耳鸣患者,耳鸣困扰程度较重(N=24),(3) 患有抑郁症但没有耳鸣的患者(重性抑郁障碍,MDD;N=23)和(4) 健康对照组(N=42)。我们使用焦虑、抑郁和躯体化症状的临床问卷评估了他们的临床特征。使用典型判别分析对数据进行了分析,得出了两个因素。第一个因素称为一般精神病理学,因为大多数问卷在这一因素上的得分都很高。在这个因素上,严重耳鸣困扰的患者和 MDD 对照组的受损程度同样严重。与健康对照组相比,耳鸣困扰程度较轻的患者受影响更大。两个耳鸣组在第二个因素,即躯体化方面的得分均高于两个对照组。这些结果强调了即使是轻度耳鸣也存在显著的一般精神病理学。