Department of Psychological Medicine, Otago Medical School - Dunedin Campus, University of Otago, Dunedin, New Zealand.
Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany.
Curr Top Behav Neurosci. 2021;51:361-380. doi: 10.1007/7854_2020_213.
To improve tinnitus management we have to gain more knowledge of factors that explain how a persistent distressing tinnitus develops. The central aim of this systematic review was to identify longitudinal studies that investigated psychosocial variables predicting the transition from an acute to a chronic, disabling tinnitus (i.e. tinnitus decompensation) or tinnitus outcomes in chronic tinnitus sufferers. We conducted a systematic literature search of electronic databases and searched manually reference lists. We identified 16 eligible studies: Four longitudinal studies targeted predictors of the transition from acute to chronic tinnitus and 12 longitudinal studies investigated predictors of tinnitus distress (k = 9 observational, longitudinal studies; k = 3 ecological momentary assessment [EMA] and diary studies). The results of this systematic review showed that tinnitus distress, general psychological distress, tendencies to somatize, tinnitus-related delay of sleep onset, certain health behaviors, general illness coping, and certain personality traits (e.g. neuroticism) predicted the transition from acute to chronic, disabling tinnitus. General psychological, mental disorders, tinnitus distress, tinnitus disability (e.g. in different domains of physical, emotional, and social functioning; sleep disturbances), certain health behaviors (e.g. physical exercise), the level of physical and social functioning, and the report of other somatic problems such as pain were predictors of tinnitus outcomes in chronic tinnitus patients at a later follow-up. Studies that examined psychosocial variables as predictors of tinnitus distress are rare and had substantial methodological shortcomings. Future research should focus on core outcome domains and use standardized outcome measures to improve the comparability of results from different studies. Numerous psychosocial variables that have already been investigated as correlates of tinnitus sufferers' functioning in cross-sectional studies are worth investigating with longitudinal designs in future research. Identified predictors of the transition from acute to chronic, disabling tinnitus have to be addressed by health care practitioners who commonly function as the first contact person of individuals with acute tinnitus in the healthcare system.
为了改善耳鸣管理，我们必须更多地了解导致持续性困扰性耳鸣发展的因素。本系统评价的中心目标是确定研究预测从急性到慢性、致残性耳鸣（即耳鸣恶化）或慢性耳鸣患者耳鸣结果的纵向研究。我们对电子数据库进行了系统的文献检索，并手动搜索了参考文献列表。我们确定了 16 项符合条件的研究：四项纵向研究针对从急性到慢性耳鸣转变的预测因素，12 项纵向研究调查了耳鸣困扰的预测因素（k=9 项观察性、纵向研究；k=3 项生态瞬时评估[EMA]和日记研究）。本系统评价的结果表明，耳鸣困扰、一般心理困扰、躯体化倾向、耳鸣相关入睡延迟、某些健康行为、一般疾病应对以及某些人格特质（如神经质）预测了从急性到慢性、致残性耳鸣的转变。一般心理、精神障碍、耳鸣困扰、耳鸣残疾（例如在身体、情绪和社会功能的不同领域；睡眠障碍）、某些健康行为（例如体育锻炼）、身体和社会功能水平以及报告其他躯体问题（如疼痛）是慢性耳鸣患者在后续随访中耳鸣结果的预测因素。研究心理社会变量作为耳鸣困扰预测因素的研究很少，并且存在严重的方法学缺陷。未来的研究应集中于核心结果领域，并使用标准化的结果测量方法，以提高不同研究结果的可比性。在横断面研究中，已经作为耳鸣患者功能相关因素进行了研究的众多心理社会变量值得在未来的研究中使用纵向设计进行研究。从急性到慢性、致残性耳鸣转变的预测因素必须由医疗保健从业者解决，他们通常在医疗保健系统中充当急性耳鸣患者的第一联系人。
