École d'orthophonie et d'audiologie, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.
Curr Top Behav Neurosci. 2021;51:349-359. doi: 10.1007/7854_2021_218.
In this chapter, I address the topic of tinnitus in the context of the patient's trajectory of care, with special attention to psychological comorbidities. Although most patients will cope with tinnitus and need no more than information and reassurance from professionals, a proportion of patients will need more supportive management. Assessment of psychological comorbidities is important to determine how urgent they should be seen in the clinic and their specific needs. The most frequent complaints are stress, depression, and anxiety. Although the direction of this relationship is still unclear (are comorbidities at the origin of tinnitus or are they a consequence of it), it is evident that the more serious comorbidities are at the onset of tinnitus, the worse the prognosis. Therefore, an assessment at the initial visit in the clinic is of utmost importance. There are valid and reliable psychometric tools to quickly draw a portrait of the psychological state of patients that can be used by audiologists, psychologists, or doctors. Therapeutic avenues can then be discussed with the patients to ensure them the best support possible.
在这一章中,我将从患者的治疗轨迹的角度来讨论耳鸣的问题,特别关注心理合并症。虽然大多数患者会应对耳鸣,只需要专业人员提供信息和安慰,但有一部分患者将需要更多的支持性管理。评估心理合并症对于确定他们在诊所中应多快就诊以及他们的具体需求非常重要。最常见的抱怨是压力、抑郁和焦虑。尽管这种关系的方向尚不清楚(合并症是耳鸣的起源还是它的后果),但很明显,在耳鸣发作时,合并症越严重,预后越差。因此,在诊所的初次就诊时进行评估至关重要。有有效的和可靠的心理计量工具可以快速描绘患者的心理状态,听力学家、心理学家或医生都可以使用这些工具。然后可以与患者讨论治疗途径,以确保为他们提供最好的支持。